Student Health: Factors Affecting Academic Success

1. Student Health: Factors Affecting Academic Success Corie Beckermann, Director of Health Services Dr. Brent Nielsen, Medical Director St. Cloud State University Fall 2008

2. Outline of Presentation • Overview of Health Services, The ACHA, and NCHA • A look at our data from Spring 2008 with a focus on what students say affects academic success • Current resources on our campus • Questions and comments

3. St Cloud State UniversityStudent Health Service • Medical clinic - we are nationally accredited with 10,000+ visits annually and 5 providers • Pharmacy – approximately 12,000 prescriptions filled annually • Lab - accredited • Health Promotions – campus outreach • Located in bottom floor of Hill Hall

4. National College Health Assessment The American College Health Association-National College Health Assessment (ACHA-NCHA) is a national research survey organized by the ACHA to assist college health service providers, health educators, counselors, and administrators in collecting data about their students' habits, behaviors, and perceptions on the most prevalent health topics.

5. National College Health Assessment ACHA initiated the survey in 1998; the survey now provides the largest known comprehensive data set on the health of college students, providing the college health and higher education fields with a vast spectrum of research on student health.

6. National College Health Assessment • Random sample of classes in February 2008 • The results of the ACHA-NCHA Spring 2008 survey, for Saint Cloud State University, included 833 respondents. • In 2007 there were 71,860 students who responded from 107 schools across the nation

7. Possible Uses of the ACHA-NCHA • Determine priority health issues among student populations. • Provide prevalence rates and formulate baseline data for tracking trends. • Measure progress and effectiveness of intervention strategies. • Assess the correlation between one characteristic or behavior and another in a given population. • Identify students’ level of self-knowledge about health protection practices and illnesses. • Identify students’ perceptions about peer behavior. • Assess the impact of health and behavior factors on academic performance.

8. General Question Content of the NCHA A. General Health of College Students B. Preventive Health C. Academic Impacts D. Violence E. Alcohol, Tobacco, and Other Drug Use F. Sexual Behavior G. Nutrition and Exercise H. Mental Health I. Student Demographics

9. Student’s View of General Health • 59.0 % of students surveyed (64.9 % male and 56.7 % female) described their health as very good or excellent.

10. General Health & GPA • Simple correlation, r=.086, p<.05 • (significant, not by chance) • There is a positive relationship • Those who rated their health as excellent had higher GPAs on average

11. Students with Excellent Health

12. Students with Poor Health

13. Frequency of Health Problems in the Past School Year 1. Back pain: 45.6% 2. Allergy problems: 36.5% 3. Sinus Infection: 26.2% 4. Depression: 16.7% 5. Strep Throat: 14.3% 6. Anxiety: 12.7% 7. Asthma: 10.5% 8. Ear infection: 9.1% 9. Bronchitis: 7.8% 10. SAD: 7.2% 11. Broken Bone: 6.1% 12. Substance abuse: 4.3% 13. Stress Injury: 3.9% 14. Mono: 3.7% 15. Fatigue: 3.4% 16. High blood pressure: 3.3%

14. Frequency of Health Problems in the Past School Year 17. Genital Warts/HPV: 2.5% 18. High Cholesterol: 2.4% 19. Bulimia: 2.0% 20. Anorexia: 1.5% 21. Chlamydia: 1.2% 22. Diabetes: 1.0% 23. Hepatitis B or C: 0.5% 24. Tuberculosis: 0.4% 24. Genital Herpes: 0.4% 26. Gonorrhea 0.1% 26. Endometriosis: 0.1% 26. Pelvic inflammatory: 0.1% 27. HIV infection: 0.0%

15. Academic Impacts • Within the last school year students reported the following factors affecting their individual academic performance, i.e. received an incomplete, dropped a course, received a lower grade in a class, on an exam, or on an important project:

16. Academic Impacts: Greatest to Least 1. Stress: 29.1% 2. Sleep Difficulties: 23.2% 3. Cold/flu/sore throat: 22.9% 4. Concern for a troubled friend or family member: 14.0% 5. Depression/anxiety disorder/seasonal affective disorder: 11.8% 6. Relationship difficulty: 11.6% 7. Internet use/computer games: 11.2% 8. Death of a friend/ family member: 9.6% 9. Attention deficit disorder: 7.4% 10. Sinus Infection/ear infection/bronchitis/strep throat: 7.3% 11. Drug Use: 3.5% 12. Mononucleosis: 3.0% 13. Learning Disability: 2.8% 14. Injury: 2.8% 15. Allergies: 2.2%

17. Academic Impacts: Greatest to Least 16. Chronic Pain: 2.1% 17. Assault (sexual): 1.8% 18. Chronic illness(diabetes,asthma,etc): 1.7% 19. Assault (physical): 1.0% 20. Eating disorder/problem: 0.9% 21. Pregnancy (yours or partner’s) 0.8% 22. Sexually transmitted disease: 0.7% 23. HIV infection: 0.3%

18. What is Stress? • It is the body’s response to physical and psychological demands. • Since stress is a broad concept it is hard to define what students mean when they say, “stress affects academic performance.” • Some examples: • Academic stress • Psychosocial stress • Financial stress • Physical stress • Occupational

19. Predictors of Stress • Sleep difficulty & Stress (r=.650, p<.05) • Relationship difficulty & Stress (r=.431, p<.05) • Internet and Games & Stress (r=.318, p<.05) • Anxiety (last year) & Stress (r=.289, p<.05)

20. Stress and GPA • Stress itself had no significant relationship with GPA • However, some of the predictors of stress did relate to student GPA • Sleep difficulty & GPA (r=.110, p<.05) • Internet and Games & GPA (r=.088, p<.05)

21. Sleep Problems • Reported by students as the second most common health issue which affected academic performance

22. Academic Impacts: Greatest to Least 1. Stress: 29.1% 2. Sleep Difficulties: 23.2% 3. Cold/flu/sore throat: 22.9% 4. Concern for a troubled friend or family member: 14.0% 5. Depression/anxiety disorder/seasonal affective disorder: 11.8% 6. Relationship difficulty: 11.6% 7. Internet use/computer games: 11.2% 8. Death of a friend/ family member: 9.6% 9. Attention deficit disorder: 7.4% 10. Sinus Infection/ear infection/bronchitis/strep throat: 7.3% 11. Drug Use: 3.5% 12. Mononucleosis: 3.0% 13. Learning Disability: 2.8% 14. Injury: 2.8% 15. Allergies: 2.2%

23. Getting enough sleep to feel rested in the morning

24. Evaluation of Sleep • Detailed history including stressors, medications, drug use and sleep hygiene • Counseling on importance of regular sleep schedule and other sleep hygiene measures (we review how the patients lifestyle/habits negatively impact sleep) • Medications are sometimes indicated when related to other health problems

25. Mental Health/Depression Depression is reported by students as one of the top health problems which impacts academic success

26. Academic Impacts: Greatest to Least 1. Stress: 29.1% 2. Sleep Difficulties: 23.2% 3. Cold/flu/sore throat: 22.9% 4. Concern for a troubled friend or family member: 14.0% 5. Depression/anxiety disorder/seasonal affective disorder: 11.8% 6. Relationship difficulty: 11.6% 7. Internet use/computer games: 11.2% 8. Death of a friend/ family member: 9.6% 9. Attention deficit disorder: 7.4% 10. Sinus Infection/ear infection/bronchitis/strep throat: 7.3% 11. Drug Use: 3.5% 12. Mononucleosis: 3.0% 13. Learning Disability: 2.8% 14. Injury: 2.8% 15. Allergies: 2.2%

27. College students reported being diagnosed with depression

28. Of those students reporting ever having been diagnosed with depression in the item above...

29. Feeling things were hopeless

30. Feeling overwhelmed by all they had to do

31. Feeling exhausted (not from physical activity)

32. Feeling very sad

33. Feeling so depressed it was difficult to function

34. Seriously considering attempting suicide

35. Attempting suicide

36. Evaluation of Student with Symptoms of Depression • Detailed history with a focus on multiple stressors and specific areas of symptoms • Student can be initially evaluated at the counseling center or health services, whichever they prefer • Student specific therapy/counseling and medications are initiated by on campus staff when indicated

37. # of Mental Health Visits per Year to Health Services

38. URIs (Upper Respiratory Infections) • At least 1/3 of our total visits annually • Examples include flu, mono, sinus infections, ear infections, strep throat, pneumonia and the common cold • Many URIs are self-limiting, but can impact academic performance (flu, mono, high fever illnesses). Many URIs affect sleep temporarily.

39. Academic Impacts: Greatest to Least 1. Stress: 29.1% 2. Sleep Difficulties: 23.2% 3. Cold/flu/sore throat: 22.9% 4. Concern for a troubled friend or family member: 14.0% 5. Depression/anxiety disorder/seasonal affective disorder: 11.8% 6. Relationship difficulty: 11.6% 7. Internet use/computer games: 11.2% 8. Death of a friend/ family member: 9.6% 9. Attention deficit disorder: 7.4% 10. Sinus Infection/ear infection/bronchitis/strep throat: 7.3% 11. Drug Use: 3.5% 12. Mononucleosis: 3.0% 13. Learning Disability: 2.8% 14. Injury: 2.8% 15. Allergies: 2.2%

40. URIs (continued) • We provide high quality care with timely visits – most prescriptions and lab tests are available on site • Prevention (flu shots), self-care (proper sleep), and basic hygiene (hand washing and covering your cough) are important. Education regarding these issues is accomplished at most visits and critical.

41. Conclusions • Health issues affect students’ ability to succeed in college. • Mental health related problems and URIs are especially prevalent here and nationwide. • Being aware of what affects students academically and the resources we have on campus will empower us to assist students who are at greatest risk.

42. Resources on our Campus for students with health problems • 1. Health Services 308-3191 • 2. Counseling Center 308-3171 • 3. Student Disability Services 308-4080 • 4. Women’s Center 308-6408 • 5. Behavioral Intervention Team 308-3111 • 6. Case Manager position • 7. Psychiatrist hours and Phone Consults

43. Behavioral Intervention Team • A group of campus administrators from student life, public safety, and the president’s office who meets on a weekly basis to discuss students of concern on campus • Most are referrals from faculty, residential life, and public safety • A plan is developed for each student

44. Case Manager • Planned hire for 2008-2009 school year to assist the above areas from the BIT team in connecting students in need with resources

45. Psychiatry Hours/Phone Calls • We have one hour per week of face-to-face time and one hour per week of phone consultation for challenging cases. Triage for these few spots is challenging. • We share these hours with St. Ben’s, St. John’s, and St. Cloud Technical College • Grant funded by Centracare

46. Credits Thank you to: John Buckner, Dept of Psychology Yawovi “Sessi” Komlanvi, Dept of Economics Rebecca Bullert, Dept of Community Health April Basarich, Dept of Psychology

47. Questions or Comments?

48. END

49. A Refresher on Statistics • P values: significance at p<.05 means we are 95% confident the relationship is not by chance, there is only a 5% chance that we found this relationship without it actually existing in the population • Interpreting correlations (r values): • r values range from -1 to 1. An r value of 0 means there is no correlation • Positive r values means they move the same direction • Ex: as Health goes up, GPA goes up… as health goes down, GPA goes down • Negative means they move opposite directions • Ex: Sleep difficulty goes down, GPA goes up… sleep difficulty goes up, GPA goes down