College students' intentions to assist peers with chronic medical conditions.

Objective This study identified influences on college students' intentions to assist peers with chronic medical conditions. Participants: A panel of 293 U.S. full-time college students completed online surveys in July, 2017. Methods: Participants reported the number of people they knew with chronic medical conditions, and completed measures of general empathy, stigma toward chronic conditions, self-efficacy to provide support, and expected likelihood of assisting a peer with a chronic medical condition. Path Analysis and mediation tests were performed. Results: Low stigma, and high confidence in providing support were directly associated with intentions to assist student peers if needed. Empathy and number of people known with chronic conditions were additional indirect predictors. Conclusions: Peer support is important for students with chronic medical conditions. Intention to provide assistance if needed is partially explained by holding low stigma and high confidence in providing support, both of which may be enhanced through education and intervention.

Decision-Making Involvement, Self-Efficacy, and Transition Readiness in Youth With Sickle Cell Disease.

BACKGROUND: Transition to adult healthcare is a critical time for adolescents and young adults (AYAs) with sickle cell disease, and preparation for transition is important to reducing morbidity and mortality risks associated with transition. OBJECTIVE: We explored the relationships between decision-making involvement, self-efficacy, healthcare responsibility, and overall transition readiness in AYAs with sickle cell disease prior to transition. METHODS: This cross-sectional, correlational study was conducted with 50 family caregivers-AYAs dyads receiving care from a large comprehensive sickle cell clinic between October 2019 and February 2020. Participants completed the Decision-Making Involvement Scale, the Sickle Cell Self-Efficacy Scale, and the Readiness to Transition Questionnaire. Multiple linear regression was used to assess the relationships between decision-making involvement, self-efficacy, healthcare responsibility, and overall transition readiness in AYAs with sickle cell disease prior to transition to adult healthcare. RESULTS: Whereas higher levels of expressive behaviors, such as sharing opinions and ideas in decision-making, were associated with higher levels of AYA healthcare responsibility, those behaviors were inversely associated with feelings of overall transition readiness. Self-efficacy was positively associated with overall transition readiness but inversely related to AYA healthcare responsibility. Parent involvement was negatively associated with AYA healthcare responsibility and overall transition readiness. DISCUSSION: While increasing AYAs' decision-making involvement may improve AYAs' healthcare responsibility, it may not reduce barriers of feeling unprepared for the transition to adult healthcare. Facilitating active AYA involvement in decision-making regarding disease management, increasing self-efficacy, and safely reducing parent involvement may positively influence their confidence and capacity for self-management.

Young Adults' COVID-19 Testing Intentions: The Role of Health Beliefs and Anticipated Regret.

PURPOSE: Young adults are at high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and transmission due to their social behaviors. The purpose of this study was to determine their attitudes toward coronavirus disease 2019 (COVID-19) testing, an important approach for minimizing infection and transmission. METHODS: One hundred seventy eight US individuals aged 19-25 years completed an online survey measuring COVID-19 health beliefs and testing intentions. Multivariable logistic regression evaluated the association of heath belief measures (perceived COVID-19 susceptibility, COVID-19 severity, barriers and benefits to testing, and social concerns) with testing intentions. RESULTS: Most respondents (86.0%) intended to accept a COVID-19 test if recommended by a health professional. High social concern and low perceived obstacles were associated with intent to get tested. CONCLUSIONS: In this sample, most young adults intended to accept COVID-19 testing. Health beliefs predicted testing intention and point to possible intervention approaches to increase willingness to accept COVID-19 testing.

Managing chronic conditions in college: Findings from prompted health incidents diaries.

OBJECTIVE: This pilot study assessed an electronic health diary method designed to collect data about critical health incidents experienced by college students who have chronic health conditions. PARTICIPANTS: Nine university students with chronic medical conditions were recruited to complete a series of e-mail-based surveys, sent once every 3 days across the fall 2014 semester. METHODS: In each survey, participants described a health-related incident that occurred within the past day and cited resources that helped or could have helped in that situation. They completed follow-up interviews and ranked the importance of cited resources. RESULTS: The diary completion rate was 78.3% (141/180). Most frequently affected management areas were activities (61.3%), monitoring (34.9%), and problem-solving (34.3%). Resources considered helpful included situational knowledge, campus health professionals, peer support, and relaxation opportunities. CONCLUSIONS: Prompted health incidents diary method achieved a high completion rate and provided data that could be useful for college health researchers and practitioners.

Transitioning through college with diabetes: themes found in online forums.

OBJECTIVE: Content analysis of Internet-based diabetes forum text was used to examine the experiences encountered by students with diabetes transitioning into and through college. PARTICIPANTS: Forum posts (N = 238) regarding attending college with diabetes were collected and analyzed. METHODS: Thematic coding was used to identify prominent topics, followed by analysis of theme distribution across college transitional stages. Three students with diabetes were recruited to review results and corroborate findings. RESULTS: Twenty thematic categories were identified. Preparation for college involved efforts to move toward autonomous diabetes management. Transitioning in was marked by adjusting to a college lifestyle, then working to manage issues such as busy schedules and alcohol use as continuing students, and turning attention toward future career options and finances while transitioning out. CONCLUSIONS: As they move into and through college, students with diabetes negotiate developmental and diabetes-specific tasks within an environment that presents unique logistical, lifestyle, and psychological challenges.

Association of acculturation with drinking games among Hispanic college students.

OBJECTIVE: This cross-sectional study was conducted to investigate which components of acculturation relate to drinking games participation among Hispanic college students. We also sought to examine whether the relationships between acculturation and drinking games would differ from the associations between acculturation and other alcohol-related outcomes. METHOD: A sample of 1,397 Hispanic students aged 18-25 (75% women; 77% US-born) from 30 US colleges and universities completed a confidential online survey. RESULTS: Associations among acculturative processes, drinking games participation, general alcohol consumption, and negative drinking consequences differed across gender. Most significant findings emerged in the domain of cultural practices. For women, US cultural practices were associated with greater general alcohol consumption, drinking games frequency, and amount of alcohol consumed while gaming, whereas for men, US cultural practices were associated with general alcohol consumption and negative drinking consequences. CONCLUSIONS: Hispanic and US cultural practices, values, and identifications were differentially associated with drinking games participation, and these associations differed by gender. It is therefore essential for college student alcohol research to examine US culture acquisition and Hispanic culture retention separately and within the domains of cultural practices, values, and identifications.

An introduction to the composition of the Multi-Site University Study of Identity and Culture (MUSIC): a collaborative approach to research and mentorship.

The Multi-Site University Study of Identity and Culture (MUSIC) is the product of a research collaboration among faculty members from 30 colleges and universities from across the United States. Using Katz and Martin's (1997, p. 7) definition, the MUSIC research collaboration is "the working together of researchers to achieve the common goals of producing new scientific knowledge." The collaboration involved more than just coauthorship; it served "as a strategy to insert more energy, optimism, creativity and hope into the work of [researchers]" (Conoley & Conoley, 2010, p. 77). The philosophy underlying the MUSIC collaborative was intended to foster natural collaborations among researchers, to provide opportunities for scholarship and mentorship for early career and established researchers, and to support exploration of identity, cultural, and ethnic/racial research ideas by tapping the expertise and interests of the broad MUSIC network of collaborators. In this issue, five research articles present innovative findings from the MUSIC datasets. There are two themes across the articles. Research is emerging about broadening the constructs and measures of acculturation and ethnic identity and their relation to health risk behaviors and psychosocial and mental health outcomes. The second theme is about the relationship of perceived discrimination on behavioral and mental health outcomes among immigrant populations.

The Association Between Sensation Seeking and Well-Being Among College-Attending Emerging Adults.

Sensation seeking is a known risk factor for unsafe and reckless behavior among college students, but its association with well-being is unknown. Given that exploration plays an important psychosocial role during the transition to adulthood, we examined the possibility that sensation seeking is also associated with psychological well-being. In a large multisite US college sample (N = 8,020), scores on the Arnett Inventory of Sensation Seeking were positively associated with risk behavior, psychological well-being, and eudaimonic well-being. When sensation seeking dimensions were examined separately, well-being was found to be associated with high novelty seeking but with low intensity seeking.

Reasons for Low Pandemic H1N1 2009 Vaccine Acceptance within a College Sample.

This study examined health beliefs associated with novel influenza A (H1N1) immunization among US college undergraduates during the 2009-2010 pandemic. Undergraduates (ages 18-24 years) from a large Midwestern University were invited to complete an online survey during March, 2010, five months after H1N1 vaccines became available. Survey items measured H1N1 vaccine history and H1N1-related attitudes based on the health belief literature. Logistic regression was used to identify attitudes associated with having received an H1N1 vaccine, and thematic analysis of student comments was conducted to further understand influences on vaccine decisions. Among the 296 students who participated in the survey, 15.2% reported having received an H1N1 vaccine. In regression analysis, H1N1 immunization was associated with seasonal flu vaccine history, perceived vaccine effectiveness, perceived obstacles to vaccination, and vaccine safety concerns. Qualitative results illustrate the relationship of beliefs to vaccine decisions, particularly in demonstrating that students often held concerns that vaccine could cause H1N1 or side effects. Vaccine safety, efficacy, and obstacles to immunization were major considerations in deciding whether to accept the H1N1 pandemic vaccine. Therefore, focusing on those aspects might be especially useful in future vaccine efforts within the college population.

The Questionnaire for Eudaimonic Well-Being: Psychometric properties, demographic comparisons, and evidence of validity.

The Questionnaire for Eudaimonic Well-Being (QEWB) was developed to measure well-being in a manner consistent with how it is conceptualized in eudaimonist philosophy. Aspects of eudaimonic well-being assessed by the QEWB include self-discovery, perceived development of one's best potentials, a sense of purpose and meaning in life, intense involvement in activities, investment of significant effort, and enjoyment of activities as personally expressive. The QEWB was administered to two large, ethnically diverse samples of college students drawn from multiple sites across the United States. A three-part evaluation of the instrument was conducted: (1) evaluating psychometric properties, (2) comparing QEWB scores across gender, age, ethnicity, family income, and family structure, and (3) assessing the convergent, discriminant, construct, and incremental validity of the QEWB. Six hypotheses relating QEWB scores to identity formation, personality traits, and positive and negative psychological functioning were evaluated. The internal consistency of the scale was high and results of independent CFAs indicated that the QEWB items patterned onto a common factor. The distribution of scores approximated a normal curve. Demographic variables were found to predict only small proportions of QEWB score variability. Support for the hypotheses tested provides evidence for the validity of the QEWB as an instrument for assessing eudaimonic well-being. Implications for theory and future research directions are discussed.

Identity consolidation and health risk behaviors in college students.

OBJECTIVES: To investigate the protective role of personal identity consolidation against health risk behaviors in college-attending emerging adults. METHODS: A multisite sample of 1546 college students completed measures of personal identity consolidation and recent risk behavior engagement. RESULTS: Multivariate Poisson regression indicated that personal identity consolidation was negatively related to binge drinking, illicit drug use, sexual risk behaviors, and risky driving. These findings were consistent across gender, ethnicity, and place of residence. CONCLUSIONS: A consolidated sense of personal identity may protect college-attending emerging adults from health-compromising behaviors. Health professionals could incorporate an identity development component into college health programming.

Alcohol management strategies of college students with diabetes.

OBJECTIVE: Alcohol management strategies of college undergraduates with diabetes were studied in order to identify which strategies were associated with decreased alcohol consumption and consequences. METHODS: Data came from 450 undergraduates with diabetes who were among 90,000 students from 123 postsecondary institutions who completed the Spring, 2006 National College Health Assessment. RESULTS: A majority of respondents (68.0%) reported alcohol use in the previous month, with 41.8% consuming five or more drinks in one sitting during the previous 2 weeks. High alcohol management strategy use in the past year was associated with fewer heavy drinking episodes and fewer alcohol-related consequences. Two strategies, avoiding drinking games and pacing one's drinking, were especially strong predictors of reduced consumption and consequences, and were more common among older students. CONCLUSION: Developing effective strategies to manage alcohol intake is especially important for students with diabetes due to short- and long-term hazards of excessive drinking. PRACTICAL IMPLICATIONS: Alcohol use is a common aspect of college culture and may hold perceived social benefits for students. Healthcare clinicians should help students with diabetes to identify alcohol management strategies that are perceived as effective and feasible. Avoiding drinking games and pacing drinks appear to be strategies especially worthy of promotion.

College student invulnerability beliefs and HIV vaccine acceptability.

OBJECTIVE: To examine behavioral history, beliefs, and vaccine characteristics as predictors of HIV vaccine acceptability. METHODS: Two hundred forty-five US undergraduates were surveyed regarding their sexual history, risk beliefs, and likelihood of accepting hypothetical HIV vaccines. RESULTS: Multivariate regression analysis indicated that vaccine acceptability was predicted by lifetime sexual partners, high perceived HIV susceptibility, low danger invulnerability, and high psychological invulnerability. Low perceived risk was associated with basing decisions on vaccine cost. CONCLUSIONS: HIV vaccine acceptability was predicted by behavioral risk and perceived HIV susceptibility, but also by general feelings of invulnerability to physical and psychological harm.

Perceived Parental Relationships and Health-Risk Behaviors in College-Attending Emerging Adults.

The present study investigated the association of perceived parenting with health-risk behaviors in an ethnically diverse sample of 1,728 college-attending emerging adults. Participants completed retrospective measures of perceived maternal and paternal nurturance, connection, psychological control, and disrespect and reported their frequency of binge drinking, illicit drug use, unsafe sexual behavior, and impaired driving. Multivariate Poisson regression analyses indicated that perceived paternal acceptance was associated inversely with 6 of the 12 health-risk behaviors measured, whereas perceived mothering was related only to 2 of these health-risk behaviors. These patterns were consistent across gender, ethnicity, and family structure.

Sensation seeking and danger invulnerability: Paths to college student risk-taking.

This study examines the roles of sensation seeking and invulnerability as predictors of health compromising behaviors in a multiethnic sample of 1690 emerging adult college students (mean age = 19.8, range 18-25 years) from nine US colleges and universities. Participants completed the Arnett Sensation Seeking Inventory and the Adolescent Invulnerability Scale; and reported how often they had participated in a set of health compromising risk behaviors (i.e., substance use, impaired driving, and sexual behaviors) in the 30 days prior to assessment. Sensation seeking and danger invulnerability scores were moderately correlated (r = .30). Findings from a series of multivariate Poisson regression analyses suggest that when considered simultaneously as predictors, sensation seeking appears to be a general risk factor associated with engagement in a variety of risk behaviors, whereas danger invulnerability is primarily a factor in those risk behaviors that are less common among peers (e.g., hard drug use, casual sex, and driving while intoxicated).

'I have cystic fibrosis': an analysis of web-based disclosures of a chronic illness.

AIM: This study examined instances where individuals with cystic fibrosis disclosed their illness on the World Wide Web, better understand their experiences and needs across stages of the lifespan. BACKGROUND: Disclosing one's chronic illness is typically done purposefully, so examining those disclosures allows a naturalistic window into individuals' experiences and needs. This study is unique to Internet-based studies of chronic illness in that data are not limited to interactions at health-related websites, but include disclosure instances gathered across a variety of Internet contexts. DESIGN: Qualitative content analysis with a summative component was used. METHOD: A web-based search engine was used to identify all web pages containing the phrases 'I have cystic fibrosis' and 'I have cf' (n = 277). Constant comparative analysis methods were used to identify thematic categories of context. Quantitative methods were used to examine age-related differences in the distribution of those disclosure statements. Findings were interpreted within a framework of Erikson's lifespan psychosocial theory. RESULTS: Adolescents (13-18 years) most frequently expressed psychosocial concerns and enlisted social support. Emerging adults (19-25 years) tended to present cystic fibrosis as just one of many self-characteristics. Adults (>25 years) tended to reach out to support others with cystic fibrosis. CONCLUSIONS: The study identified age-related differences in the types of illness disclosures found among individuals with cystic fibrosis. It also demonstrated that web-based research into chronic illness need not be limited to analysis of illness-specific online communities. RELEVANCE TO CLINICAL PRACTICE: Findings suggest that psychosocial interventions for individuals with cystic fibrosis across the lifespan might focus on (a) facilitating social support and incorporating illness into one's emerging identity among adolescents, (b) supporting emerging adults in presenting and incorporating themselves into larger social networks and (c) partnering with adults who wish to mentor others living with cystic fibrosis.

Online forum messages posted by adolescents with type 1 diabetes.

PURPOSE: Messages posted by adolescents with diabetes at public Web-based forums were assessed using content analysis. METHODS: Messages (n = 340) from adolescents self-identified as having diabetes were collected from public online discussion and question/answer forums and coded with respect to age, gender, duration of illness, and purpose of the post. Request messages were analyzed using a constant comparative method to generate descriptive categories. Nonparametric tests assessed for differences among groups and between forum types and request topics. RESULTS: Most messages were from females who more often posted at discussion forums. Males posted more information requests. Six categories emerged from the analysis: life tasks, social support, medical care, factual information, management, and intrapsychic. Social support messages accounted for half of discussion forum requests; information/management requests were common in question/answer forums. CONCLUSIONS: Data suggest that adolescents with diabetes visit online forums for social support, information, advice, and shared experience. Females used discussion forums more frequently and males requested more information.