Health risk behaviors among students attending 4-year colleges in California were examined. The Youth Risk Behavior Survey for College Students was administered in a two-stage (29 universities, 5,652 students) random sample. All campuses and 3,810 (69%) students participated in the survey. In the 30 days preceding the survey, 36.7% of the students had binged at least once while drinking; 25.3% had driven after consuming alcohol; 32% had ridden in a car with someone who had been drinking; 17.6% had used marijuana; and 6% had carried a knife, gun, or club. More than half of the students who were sexually active and not married or living with a primary partner had not used a condom the last time they had sexual intercourse. Only 5% of regular bicycle riders always wore a helmet. Fewer than half (44%) reported aerobic physical activity on 3 or more of the preceding 7 days. The results of this study indicate a substantial amount of serious, risky health behaviors among California college students.
California college students (1,864 students from 15 colleges) were compared with students who participated in the Harvard School of Public Health College Alcohol Study, which surveyed 17,592 students in 140 colleges nationwide. California college students, in comparison with the remainder of the nation, were less frequent drinkers; less frequent binge drinkers; exhibited fewer personal problems and risks associated with heavy episodic drinking, including drinking and driving; and reported fewer "secondhand" effects of binge drinking, such as being physically assaulted or experiencing an unwanted sexual advance. Many of these differences appear to be related to the California college students' being older, more likely to be married, and less likely to live on campus than those in the Harvard study. The findings suggest that, in developing programs tailored to local needs, there is significant value in augmenting national surveillance of college student health risk behaviors with the development of regional, state, and local surveillance systems.
The development of the Internet-based World Wide Web communication platform has opened a new avenue for extending the program effectiveness of college health centers. California College Health 2000, a San Diego State University-based HIV prevention project, is collaborating with the university's student health center to develop a computer-based resource to provide hypertext links to specific health information helpful to health promotion planners and consumers. The project's virtual resource centers are organized around health topics and seek to encourage the dissemination of health information to the broadest possible constituency of college health professionals and are designed to provide for continuous feedback and to evolve over time. Implications for the future of college health, based on the creation and pilot use of the resource centers, are discussed, and recommendations are made regarding collaboration, leadership, and continuing innovations in the area of networked health information.
Given the rapidity of change in both higher education and health care, re-examining the values and precepts that undergird the profession of college health is an ongoing need. Reported in this article are the results of a structured process in which a group of college health professionals from California, along with others interested in the health of college students, examined several trends affecting higher education and health; considered possible scenarios for these sectors; created a shared vision for the future of college health; and developed strategies useful in attaining that vision. The results of these deliberations are presented as a set of principles that, if followed, should increase the likelihood that college health centers will be responsive to user needs. Although the article is based on a California-based conference, the principles discussed are almost certainly valuable for all in college health.
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