Transcript HSACCC Research committee report

California Community College Students'
Health: How to Understand and Use the
HSA-CCC Survey Findings to Promote Your
Students' Mental Health
Susan Quinn, MSN, FNP
Director Student Health Services
Santa Rosa Junior College
HSACCC Research Committee Chair
Assessing Student Health Needs
National College Health Assessment Survey
National College Health Assessment
 National benchmark instrument for college student health
 Comprehensive assessment of the health – i.e. whole student
 8 Content Sections:
•
Health, Health Education and Safety
•
Alcohol, Tobacco and Drugs
•
Sex Behavior and Contraception
•
Weight, Nutrition and Exercise
•
Mental Health
•
Physical Health
•
Impediments to Academic Performance
•
Demographics
 Online or paper survey formats
 Supplemental questions optional
How can we utilize NCHA Data?
 Health Status Trend Analysis
 Comparative Analysis between local, CCC, and National Reference Groups
 Assess student health indicators in relationship to Healthy Campus 2020 benchmarks
 College Program Planning - Identify priority health issues for CCC students
 Population based health support planning
 State/National agencies and programs
 Higher Education; links with UC/CSU systems
 Advocacy for CCC student health support
 Equity and Access to Health Services
 Inform Student Success Initiatives
 Legislative Activities
 Policy development
 Funding Requests for campus health centers
 Grant applications
 Support Research Projects, Dissertations, and Publications on CCC Students
Available Comparison Reference Groups
HEALTHY CAMPUS 2020 TARGETS
 “Sister document” to Healthy People
2020
 Created in collaboration with 25 higher
education professional organizations,
led by the American College Health
Association
 Identified health indicators included in
Healthy People 2020 aligned with
national NCHA data and set health
objectives specifically for college
students.
These Reference Groups are used
for NCHA comparisons today
CALIFORNIA COMMUNITY COLLEGES
HSACCC-NCHA Reference Group Spring 2013
 Summary data from 18 CCCs that conducted
the NCHA during Spring ’13 and participated in
the HSACCC Consortium Project.
 Sample Size: 14,502 CCC students
 Consortium data available from 2010 for trends.
AMERICAN COLLEGE HEALTH ASSOCIATION
NCHA Reference Group Spring 2013
 Summary data from all 153 colleges in the
United States and Canada that conducted
the NCHA during Spring ‘13
 Sample Size: 123,078 U.S. college students
Health Insurance
Trend CCC Students 2010 to 2013*
Comparison CCC/National 2013
70%
60%
50%
45%
National
50%
40%
CCC
CCC 2013
35%
CCC 2010
30%
40%
30%
25%
20%
20%
15%
10%
10%
5%
0%
0%
College
Plan
Parent's
Plan
Another
Plan
None
Not sure
College
Plan
Parent's Plan
Another
Plan
None
Not sure
Select Demographics
Age
60%
Gender
70%
50%
National
60%
National
CCC
40%
CCC
50%
40%
30%
30%
20%
20%
10%
10%
0%
18-20
21-24
25-29
30+
0%
Female
Male
Select Demographics
Ethnicity
White
Hispanic or Latino
Asian or Pacific Islander
Other
CCC
Biracial or Multiracial
National
American Indian or Alaskan Native
Black
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
Select Demographics
Disabilities – CCC/National 2013
Disabilities – CCC 2010/2013
ADHD
ADHD
Learning Disability
Learning Disability
Psychiatric condition
Psychiatric condition
Chronic illness
Chronic illness
Other disability
Other disability
Deafness/Hearing…
Deafness/Hearing loss
Partial…
Partial…
CCC 2013
Speech of language…
National 2013
Speech of…
Mobility/Dexterity…
Mobility/Dexterity…
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
CCC 2010
CCC 2013
0.0% 2.0% 4.0% 6.0% 8.0% 10.0%
Some Ethnicity Breakouts on Demographics
No Health Insurance
Other
Native American
Asian
Black
Multi
Latino
White
Aggregate
0.0%
5.0%
10.0% 15.0% 20.0% 25.0% 30.0% 35.0%
Some Ethnicity Breakouts on Demographics
Disability -ADHD
Other
Native American
Asian
Black
Multi
Latino
White
Aggregate
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
Some Ethnicity Breakouts on Demographics
Learning Disability
Other
Native American
Asian
Black
Multi
Latino
White
Aggregate
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
Some Ethnicity Breakouts on Demographics
Psychiatric condition
Other
Native American
Asian
Black
Multi
Latino
White
Aggregate
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
Academic Performance
Some Different Ways to Look at It,
and An Example of Diving Into the
Detail on One Issue
Negative Impact on Academic Success
Stress
Work
Sleep Difficulties
CCC
Anxiety
National
Cold/Flu/Sore Throat
Depression
Finances
Internet Use/Computer games
Relationship Difficulty
Concern for a troubled friend/family
0%
5%
10%
15%
20%
25%
30%
35%
Academic Performance
Healthy Campus 2020 Targets
Negative Impact on Academic Performance
35.0%
30.0%
National
CCC
HC 2020 Target
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
Cold/Flu/Sore
Throat
Anxiety
Sleep
Difficulties
Work
Stress
ANXIETY negatively impacting academic
performance - by ethnicity - CCC students
Other
Native American
Asian
Black
Multi
Latino
White
Aggregate
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
Conditions Diagnosed and/or Treated Within the Last 12
Months – CCC- Physical and Mental Health (Top 20)
Allergy problems
Back pain
Anxiety
Depression
Sinus infection
Urinary Tract Infection
Migraine Headache
Asthma
Strep throat
Broken bone/fracture
Panic attacks
Ear infection
Insomnia
High blood pressure
Bronchitis
ADHD
High cholesterol
Other sleep disorder
Other mental health condition
Obsessive Compulsive Disorder
0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0% 20.0%
ANXIETY – Diagnosed and/or Treated in the Last 12 Months
CCC Students by Ethnicity
Other
Native American
Asian
Black
Multi
Latino
White
Aggregate
Female
Male
0.0%
2.0%
4.0%
6.0%
8.0%
10.0% 12.0% 14.0% 16.0% 18.0%
Anxiety/Depression – Of Students With A Diagnosis
Made, The % Receiving Treatment of Any Kind
Depression
HC 2020 Target
CCC
National
Anxiety
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
Anxiety and Academic Performance
SRJC NCHA Data 2013 – by Ethnicity
Results were obtained using a series of cross tabulations with chi-square analysis
Hispanic Populations
The following issues displayed significant or approaching-significant results for the relationship
between the issue and academic performance (Question 45):
 Anxiety (very strong indicator of significance p<.001)
 Concern for family (p=.025)
 Death of a family member (p=.05)
 Depression (p=.024)
 Sleeping difficulties (approaching significance p=.051)
Issues were also examined by gender within the Hispanic population to see whether specific
issues pertain more to one gender or another. The following results showed a significant
relationship with a specific gender within the Hispanic sample:
 Anxiety, females (p=.002)
 Concern for family, female (p=.017)
 Death of a family member, female (p=.048)
 Depression, male (p=.047)
 Finances, female (p=.045)
Other Data of Interest
Relationship Violence
Sexually abusive relationship
Emotionally abusive relationship
Physically abusive relationship
A physical assault
HC 2020 Target
CCC
Sexual penetration without consent
National
Sexual touching without consent
0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0%
Negative Consequences of Drinking Alcohol
Doing something they regretted
Forgetting location/actions
Unprotected Sex
Being Physically Injured
Trouble with the Police
Physically Injured Another
Drove Car After 5 or More Drinks
CCC
National
Seriously Considered Suicide
Had Sex Without Giving Consent
Had Sex Without Getting Consent
0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0%
Substance Abuse - Marijuana
70.0%
60.0%
50.0%
National
CCC
40.0%
30.0%
20.0%
6.2%
10.0%
0.0%
Never
Ø Last 30
Days
Used 1-9
Days
Used 10-29
Days
Used All 30
Days
Any use
within the
last 30 days
An example of the value of local data, compared with
national and state data, by gender breakout (males only)
60.0%
National
50.0%
CCC
34.5%
SRJC
40.0%
30.0%
16.1%
20.0%
10.0%
0.0%
Never
Ø Last 30 Days
Used 1-9 Days
Used 10-29 Days Used All 30 Days
Any use within
the last 30 days
Traumatic/Difficult to Handle Last 12 Months
Finances
Academics
Family problems
Sleep difficulties
Intimate relationships
National
Career-related issue
Personal appearance
CCC
Other social relationships
Health problem of family member/partner
Personal health issue
Death of family member or friend
Other
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
50.0%
Suicide
Attempted suicide
HC 2020 target
CCC
National
Seriously considered suicide
0.0% 1.0% 2.0% 3.0% 4.0% 5.0% 6.0% 7.0% 8.0% 9.0%10.0%
Dissemination of Health Information
Percent of students that received information from the college on the following….
Physical Activity
Nutrition
STD/I Prevention
Pregnancy Prevention
AOD Use
Tobacco Use
HC 2020 Target
CCC
Suicide Prevention
National
Violence Prevention
Injury Prevention
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Next Steps
 Additional trend and comparison data from Executive Summary
reports is easy and accessible to all! 2007, 2010 and 2013 CCC
Consortium Executive Summaries are all available for these
relatively simple reports.
 If you did a local NCHA survey, do your own comparison analysis.
 You may request a customized SPSS file or other report from the
HSACCC Consortium Database to support your more focused and
in-depth research questions, for a specific project or dissertation.
 Complete a HSACCC research request form (on web site)
 Submit to Research Committee for review.
 SRJC’s Office of Institutional Research will prepare this once approved by HSACCC.
 Dissertation topics?
Health Services Programs
within the CCC System
HSACCC Annual Survey
HSACCC Annual Survey
 Benchmark survey for CCC Health Services
 Started 2008-2009 academic/fiscal year
 Administered online via Survey Monkey
 81 Questions
 7 Sections: Demographics, Compliance, Funding ,
Staffing, Scope of Service, Outcomes, Mental
Health
 30 colleges participated in 2012-2013
 Survey for the 13-14 Academic/Fiscal Year is out
and ready to be completed (by November 14th)
Uses of HSACCC Annual Survey
 Collects organized and easily reportable data on the infrastructure
and program activities of Health Services in the CCC system.
 Assists in orienting health services professional staff coming into the
CCC system, regarding compliance, program development and
administrative issues in our setting.
 Provides ongoing informational support to Health Services personnel
on program models throughout the state for CCC health services, to
assist in local program development and advocacy efforts.
 Identifies training needs, and professional development topics for
HSACCC’s and MHWA’s conferences and meeting.
 Reduces the number of emails from our listservs asking for
information on topics we already have!
Uses of HSACCC Annual Survey
 Offers trend analysis and reporting on the status of our health
centers and services
 Preserving and enhancing the fiscal health of our services,
through collaboration with relevant agencies, grantors, and
health partners.
 Demonstrates how our services and system are dynamic and
changing quickly
 Provides a snapshot of what areas of support are needed for
our health centers, and helps prioritize system response.
 Contributes to your Program Review and Accreditation
requirements.
Health Fee Trends
100%
2011-2012
90%
2012-2013
80%
70%
60%
50%
40%
30%
20%
10%
0%
Charge the
maximum
Health Fee
Automatic HF
COLA policy
Only HF
SHS budgets
Have HF
Waivers are under $600,000 Reserve Fund
those required
by Ed. Code
HF Reserve <
$500,000
Student Health Funding Source Trend
2012-2013
2011-2012
Colleges with a
Health Fee Revenue
Health Services
Advisory
Student Charges
Committee,
District Funds
overseeing
MHSA Grant Funding
Health Fee fund
MAA Revenue
and program
planning,
Other Grant Funding
remains low,
Donations
at only 20%
Family Pact Billing
during 12-13.
Student Governement
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
100.0%
Sexual Assault Prevention and Response
Fully Compliant
2011-2012
90.0%
2012-2013
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
Written procedures
Info provided at all
orientations
Website containing all
info
Board policy including
mandates
Staffing and Employment Classification
Manager
Administrative Support Staff
Director/Coordinator
Physician
Registered Nurse
Nurse Practitioner
Psychologist
Marriage & Family Therapist
Health Educator
Medical Assistant
Clinical Social Worker
Faculty
Classified
Contracted
Full Time Equivalency
Staff
 Average 6.1FTE per
college
 Range 1.65 to 21.35
FTE.
 Temporary, Hourly,
Contract Workers =
53.3% of the
workforce
.
Health Services Director/Coordinator Tidbits
60%
50%
40%
30%
20%
10%
0%
% of Directors that are Nurse
Practitioners
% of Directors that report directly to
VP
Professional Service Visits by Type
* “Other” includes
service visits by
colleges without
capacity to report
by provider type
22 colleges reporting
132,867 service visits
Average 7849
Registered Nurse (not NP)
Other
Nurse Practitioner
Health Educator/Health Promotion…
64.3% of colleges
provide Nurse
Practitioner Services
Physician
Licensed Mental Health Provider
Mental Health Trainee/Intern
62.1% provide direct
care physician
services in health
centers
Medical Assistant
Registered Dietitian
Drug/Alcohol Counselor
Psychiatrist
20,000
40,000
60,000
% of Colleges Providing
Psychotherapy
Mental Health Services
Increase in direct mental health services
Paid for by the (diminishing) Health Fee
2012-2013
Majority of services are under the supervision of Health Services
Directors/Coordinators
2011-2012
100%
Other model
90%
74%
80%
70%
MH
contractors/employees
reporting to Other
60%
50%
MH employees report to
HS Director/Coordinator
40%
30%
76%
78%
80%
82%
84%
86%
Mental Health Services Paid for
by Health Fee
YES, 81%
MH contractors report to
HS Director/Coordinator
20%
10%
NO, 19%
0%
2011-2012 2012-2013
88%
Colleges Providing
Psychotropic Medications
Mental Health
Internship Programs
21%
80%
2011-2012
2012-2013
70%
60%
20%
20%
50%
19%
40%
19%
30%
18%
20%
18%
10%
17%
0%
% of colleges
with MH
internship
program
% of colleges
w/Psychology
interns
% of colleges
w/MFT interns
% of colleges
w/LCSW interns
17%
2011-2012
2012-2013
Colleges with a well defined
threat assessment protocol
Colleges with a Behavioral
Intervention Team (BIT)
90%
80%
70%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
0%
2011-2012
2012-2013
Yes
No
CCC BIT Functions 12-13
Faculty/Staff consultations
Receiving, responding, tracking BIR
Staff development trainings
Attend/facilitate faculty-student meetings
Student case management
Provide threat assessements
Participate in student conduct code hearings
District Policy and Procedure review,…
Team is developing, scope not clear
Other
We don't have a team
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
CCC Mental Health Services 12-13
 82% of mental health counseling services report sessions limits for students.
 64% of mental health counseling services report weekly therapy sessions
(almost always)
 51% of mental health counseling services report having a wait list.
(average wait time from 1 day to two weeks = most within a few days)
 32% of mental health counseling services report they provide mandated
therapy.
 18% of mental health counseling services report they provide
psychological testing.
 15% of mental health counseling services report charging a fee for
services.
Health Promotion and Education
 100% of health services provide classroom presentations
 97% of health services provide health awareness events
 86% of health services provide open workshops and seminars
 45% of Student Health Services departments have a Facebook
page.
 37% of colleges utilize the Student Health 101 online magazine
 35% of health services work with faculty on curriculum infusion
projects
 31% of health services have certified health educators and/or
prevention specialists working
 14% of colleges reported a structured peer support/education
program
Seminars and Workshops Offered 12-13
Contraception-STIs
Depression/Anxiety
Tobacco
Stress
Diet / Nutrition
Violence
Suicide -Other
Healthy Relationships
Colds and Flu
Substance Abuse
Immunizations
Health Fair
Fitness, Exercise
Sleep
ACA
Yoga, Meditation
Suicide - QPR
Eating Disorders
Cancer
Injury Prevention
Internet Addiction
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
Thanks to everyone that
participated in our data
collection projects!
Let’s all put it to good use!
If you have a healthcare information system, which one do you utilize?
Nuesoft
Technologies, 4.2%
SARS, 37.5%
Pyramed, 12.5%
Point and Click,
12.5%
Medicat, 20.8%
MedPro, 12.5%
During the 2012-2013 year, what type of service contact
information have you been able to collect, by any kind of data
system, in your health center? (Check all that apply)
Visits by provider type (MD, RN, MFT, etc.)
Procedures (CPT codes or other)
Mental Health Diagnostic Codes (DSM-IV or V, or
other)
Medical Diagnostic Codes (ICD-9 or other)
Types of Appointments
We do not utilize an electronic information system
0.0%
50.0%
100.0%