Campus Sexual Violence Resources and Emotional Health of College Women Who Have Experienced Sexual Assault.

Institutional characteristics may help mitigate trauma associated with sexual assault. This study examines associations between resources on college campuses for sexual violence prevention and the emotional well-being of female students who have experienced sexual assault. There were 495 female college students who have experienced sexual assault who provided survey data in 2010-2011. Sexual violence resource data from 28 college campuses were combined with student survey data in multilevel analysis. Dependent variables include diagnosis with anxiety, depression, panic attacks, and PTSD, and models adjust for covariates and clustering of students within colleges. Participants attending colleges with more sexual violence resources had lower rates of mental health conditions than those attending colleges with fewer resources. Colleges are encouraged to expand their array of sexual violence resources to create a supportive environment for victims of sexual assault and to connect affected students with appropriate services.

Differences in sexual behaviors among unmarried sexually active students at 2- and 4-year colleges.

Sexual risk behaviors are common among college students, but differences between 2- and 4-year students have not been explicitly tested. Survey data from 9,748 unmarried sexually active Minnesota college students (in 2010 or 2011) were used multilevel logistic regression models to test differences in eight high risk sexual health behaviors and outcomes between students attending 2- vs. 4-year colleges. Odds of sex without a condom, sex without reliable birth control, unplanned pregnancy, and STIs were significantly lower among 4-year students than 2-year students, after adjusting for demographic covariates. Health promotion approaches targeted to the needs of 2- or 4-year students may be needed. For example, messaging and outreach efforts encouraging condom use may be especially beneficial for sexual health programs at 2-year colleges.

College students' preferences for health care providers when accessing sexual health resources.

OBJECTIVE: Many emerging adults (18-25 year olds) report unmet health needs and disproportionately experience problems such as sexually transmitted infections. This study was conducted to examine college students' perceptions of health care providers, specifically in the context of accessing sexual health resources. DESIGN AND SAMPLE: Students (N = 52) were recruited from five diverse colleges in one state to participate in a one-to-one interview that involved walking and virtually exploring resources on and near campus. Interviews were conducted from May to November 2010. MEASURES: Open-ended one-to-one interview questions. RESULTS: Inductive qualitative analysis yielded six themes summarizing students' perceptions of provider characteristics, health care resources, the role of their peers, and students' suggestions for strengthening health care services. Importantly, students consider a variety of staff-and their student peers-to be resources for sexual health information and services. CONCLUSIONS: Findings emphasize the importance of collaboration between health service staff and broader campus staff because students often turn to campus staff initially. Postsecondary students welcome opportunities to know a provider through interactive websites that include details about providers on campus; their decisions to seek sexual health care services are influenced by their perceptions of providers' characteristics and interpersonal skills.

Problematic Internet use and associated risks in a college sample.

OBJECTIVE: The Internet is commonly used among young adults; however, Internet use may become a problematic behavior. Past research has examined Internet behavior in young adults and its relationship to other behaviors and health issues, yet further research is needed to gain a more comprehensive understanding of this relationship. METHOD: A sample (n=2108) of college students (56.9% female) was examined using a self-report Internet survey concerning demographic characteristics, Internet use, health behaviors, psychosocial functioning, and psychiatric comorbidities. The IAT was used to determine levels of problematic Internet use (limited use (none or almost no use), mild use (typical user), moderate use (occasional problems) and severe use (frequent, serious problems)) and the MINI for testing for psychiatric problems. RESULTS: We found that 237 students (12.9%) met criteria for limited Internet use, 1502 (81.8%) for mild Internet use and 98 (5.3%) for moderate to severe Internet use. Variables significantly associated with greater frequency of Internet use included lower Grade Point Average (p=.006), less frequent exercise (p=.018), higher PHQ-9 scores (p<.0001) (indicative of greater depression symptoms) and higher Perceived Stress Scores (p<.0001). CONCLUSIONS: These data indicate that moderate to severe Internet use is associated with a range of psychosocial problems in young adults. More research is needed to better understand the relationship between Internet use and physical and mental health, as well as academic variables.

Predictors of Sexual Harassment Using Classification and Regression Tree Analyses and Hurdle Models: A Direct Replication.

Sexual harassment affects a large percentage of higher education students in the US. A previous study identified several risk factors for sexual harassment using hurdle models and classification and regression tree (CART) analyses. The purpose of the present study was to assess the robustness of these findings by replicating the analyses with a new sample of students. Secondary data analysis was conducted using data from 9,552 students from two- and four-year colleges. Hurdle model coefficients were assessed for replicability based on statistical significance and consistency of the replication effect size relative to the original effect size. Kotzé et al.'s findings were robust, with 91% of all tested effects meeting at least one of two replication criteria in the hurdle models and 88% of the variables replicating in the CARTs. Being younger, consuming alcohol more frequently, attending a four-year college, and having experienced more prior victimization and adversity were important predictors of peer harassment whereas being LGBQ+ was an important predictor of sexual harassment from faculty/staff. These findings can inform targeted prevention and intervention programs. More research is needed to understand why certain demographic and contextual variables are associated with greater harassment risk.

Characterizing sexual health resources on college campuses.

This observational study describes the development of the college resources and sexual health inventory, the profile of sexual health promotion resources at participating colleges, and comparisons of resources across several college characteristics. 28 diverse college campuses in one Midwestern state participated. 10 domains were assessed, including characteristics of campus health services (e.g. convenience), condom programs, sexual health information, communication about resources, sexual violence resources and gay/lesbian/bisexual student resources. Scores for each measure reflected the presence or extent of each resource. Summary scores were created for the overall level of sexual health resources and for each domain. T tests and ANOVAs were used to compare resources at 2-year versus 4-year colleges, public versus private sectors, metro versus non-metro locations, and across enrollment size. Inventory scores ranged from 6 to 53. 4-year colleges offered significantly more resources than 2-year; resource levels were statistically similar across location and enrollment size. Subsequent analyses comparing campuses with and without a health center indicated that several resources which were not inherently tied to a clinic nonetheless differed significantly with having a health center. Colleges without this resource could position sexual health resources in other offices or departments or provide referrals to sexual health resources in the broader community.

Identifying Correlates of Peer and Faculty/Staff Sexual Harassment in US Students.

Sexual harassment and its negative consequences continue to affect a large percentage of higher education students in the US. Previous research has identified a limited number of harassment risk factors, and has generally not examined them in combination. In this study, an expanded set of individual, relationship, and community-level risk factors were examined using hurdle models and classification and regression tree (CART) analyses to identify key risk factors for peer and faculty/staff sexual harassment. Secondary data analysis was conducted using data from a sample of 9,285 students from 18 two-year and four-year schools in Minnesota. CART analyses indicated that, for peer sexual harassment, being younger; consuming alcohol more than once a month; attending a four-year school; being transgender, genderqueer, self-identified, or a cisgender woman; and having experienced bullying were the most important risk factors for peer harassment on campus. For faculty/staff harassment, being gay, lesbian, bisexual, questioning, or having a self-identified sexual orientation was the most important risk factor. These and other risk factors were significant in the hurdle models. More research is needed to understand why these factors are associated with harassment. Limitations and implications for prevention programming at higher education institutions are discussed.

Self-Reported Mental Disorders and Distress by Sexual Orientation: Results of the Minnesota College Student Health Survey.

INTRODUCTION: Sexual minority college students (i.e., those not identifying as heterosexual, or those reporting same-sex sexual activity) may be at increased risk of poor mental health, given factors such as minority stress, stigma, and discrimination. Such disparities could have important implications for students' academic achievement, future health, and social functioning. This study compares reports of mental disorder diagnoses, stressful life events, and frequent mental distress across five gender-stratified sexual orientation categories. METHODS: Data were from the 2007-2011 College Student Health Survey, which surveyed a random sample of college students (N=34,324) at 40 Minnesota institutions. Data analysis was conducted in 2013-2014. The prevalence of mental disorder diagnoses, frequent mental distress, and stressful life events were calculated for heterosexual, discordant heterosexual, gay or lesbian, bisexual, and unsure students. Logistic regression models were fit to estimate the association between sexual orientation and mental health outcomes. RESULTS: Lesbian, gay, and bisexual students were more likely to report any mental health disorder diagnosis than were heterosexual students (p<0.05). Lesbian, gay, bisexual, and unsure students were significantly more likely to report frequent mental distress compared to heterosexual students (OR range, 1.6-2.7). All sexual minority groups, with the exception of unsure men, had significantly greater odds of experiencing two or more stressful life events (OR range, 1.3-2.8). CONCLUSIONS: Sexual minority college students experience worse mental health than their heterosexual peers. These students may benefit from interventions that target the structural and social causes of these disparities, and individual-level interventions that consider their unique life experiences.

Sexual health resources at Minnesota colleges: associations with students' sexual health behaviors.

CONTEXT: Sexual risk behaviors are common among college students, and research examining the environmental context of these behaviors is important for prevention. The presence of college sexual health resources is a potentially important part of that context. METHODS: In a 2010-2011 survey, 6,318 undergraduates from 28 two- and four-year Minnesota college campuses provided data on their sexual health behaviors. In addition, a specially designed inventory was used to assess the sexual health resources available on each campus. Multilevel regression was used to test the associations of four types of resources with students' condom use, birth control use, STD or HIV testing, and unplanned pregnancy. RESULTS: In models that controlled for students' personal and demographic characteristics, the higher the level of sexual health resources at a college, the lower the likelihood that students had had intercourse without birth control, intercourse without a condom and involvement in unplanned pregnancy. For example, students attending colleges with the maximum number of general clinic resources had a lower predicted probability of reporting nonuse of reliable birth control at last intercourse than students attending colleges with no resources (7% vs. 14%). After college characteristics were adjusted for, most measures of resources remained significant, although associations were reduced; two measures became significant in unexpected directions. CONCLUSIONS: Colleges' provision of sexual health resources may be associated with students' sexual health behaviors. Research using quasi-experimental or experimental designs is needed to assess the mechanisms underlying these associations; such work could lead to interventions that might help reduce students' risky behaviors.

Preventing sexual violence instead of just responding to it: students' perceptions of sexual violence resources on campus.

Rates of sexual assault of college students are higher than the national rates. Colleges are uniquely positioned to offer preventive education and support services to a high-risk group. This qualitative study examines students' perceptions of sexual violence resources and services. Seventy-eight female and male students, between 18 and 24 years old, belonging to various demographic groups, participated in one-to-one walking interviews on five diverse Midwest 2- and 4-year postsecondary campuses. Findings suggest that students are concerned with safety--students want more education regarding sexual violence--and they value services that offer protection from incidents of sexual violence on campus. Participants expressed mixed reactions to prevention education that combined sexual violence prevention with alcohol and drug use. Students shared positive views of the security measures on campus. They emphasized the importance of using varied mechanisms for sexual violence-related resource messaging and advised moving away from the pamphlet toward posters and online resources. Recommendations are offered to strengthen existing resources, such as prevention education and postassault interventions including sexual assault nurse examiner services, and to minimize barriers to access of sexual violence resources.

Differences in tobacco use among two-year and four-year college students in Minnesota.

OBJECTIVE: This study compares tobacco use rates among two-year and four-year college students and explores the demographic variables that predicted that behavior. PARTICIPANTS: 9,931 students at 14 two-year and four-year colleges in Minnesota participated. METHODS: Students at 11 schools completed an online survey, and students at 3 schools completed a paper survey in 2007. RESULTS: After controlling for sex, age, ethnicity, relationship status, hours of work per week, and number of school credits, attending a two-year college predicted current and daily smoking (odds ratio [OR]) = 1.70, 95% confidence interval [CI] = 1.52-1.89; OR = 3.47, 95% CI = 2.94-4.11) and smokeless tobacco use (OR = 1.65, 95% CI = 1.32-2.06; OR = 1.64, 95% CI = 1.06-2.53). CONCLUSIONS: Although two-year college students comprise approximately two fifths of the college student population, surveys of college student tobacco use have focused nearly exclusively on four-year college students. Two-year college students should represent a priority population for tobacco control because attending a two-year college predicts increased tobacco use.

Smoker self-identification versus recent smoking among college students.

BACKGROUND: 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. METHODS: A total of 9931 students at 14 colleges completed a random sample survey in 2007. RESULTS: 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. CONCLUSIONS: 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.