December
15, 1998 by Jim Grizzell, jvgrizzell@csupomona.edu
Send your comments for adding, changing or revising objectives; sources of data; baseline data; or targets to the Task Force at collhlth2010@csupomona.edu. Although the comments had to be in by December 15, 1998, there are opportunities to help DHHS fine tune the next draft.
Objective - 16-5, line 43 of hard copy
Recommendation: on page 16-15, line 43 add prolonged computer
in addition to driving as relevant to large numbers of people.
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Overview
Comment developed with Lance Armstrong Foundation Board Member, Steven N. Wolff, MD at Steven.N.Wolff@mcmail.vanderbilt.edu and http://www.laf.org .
There exists a need for improving knowledge about testicular cancer (TC) and awareness of the need for testicular self-examination. (TSE). TC is the leading cancer cause of death in men ages of 15-35 accounting for 14% of all deaths.[1, 2] Although not as common as breast, prostate, lung or colon cancer, the impact of TC is still substantial. TC occurs five times more frequently in Caucasians than in African-Americans but everyone is still susceptible. It is estimated that 1 in 500 men by the age of 50 will develop TC. In addition to the absolute mortality, what is particularly worrisome, is that the overall incidence of the disease has doubled in the past 20 years and continues to rise at a yearly rate of 6%.[3] The cause of this rise is not clear but may relate to an increasingly earlier age of onset of puberty.
Testicular self-examination should be the first step for men to acquire knowledge about their needs for health awareness. Additionally, this knowledge, provided by high-school, university and college health services, could initiate self-empowerment for maintaining appropriate health habits by utilizing TSE as a model for promotion of good health standards and practices.
The value of TSE is not to detect cancer. Since the disease is uncommon, TSE will allow men to become familiar with a normal exam so that any developing abnormality will be noted.
If TC occurs, the prognosis is excellent with an overall cure rate of more than 90-95%.[4] Extent of stage at diagnosis is an important determinant for prognosis for both non-seminomatous and seminomatous tumors. The cure rate for very localized disease is close to 100%; whereas, for far-advanced disease, cure may be possible in only 50% of patients. In addition to prognosis, the stage of disease determines the type and intensity of treatment. Disease limited to the testes may be successfully treated with surgery (inguinal orchiectomy) without the need for any additional therapy. On the other hand, wide-spread disease requires intensive chemotherapy with the possibilities of additional surgery (besides orchiectomy) to resect residual masses.
Considering all of the above, TSE should become a standard practice for all men. If abnormalities are detected, men should not hesitate to seek medical attention.
1. Clore, E.R., A guide for the testicular self-examination.
J Pediatr Health Care, 1993. 7(6): p. 264-8.
2. Carlin, P.J., Testicular self-examination: a public awareness
program. Public Health Rep, 1986. 101(1): p. 98-102.
3. Moller, H., N. Jorgensen, and D. Forman, Trends in incidence
of testicular cancer in boys and adolescent men. Int J Cancer,
1995. 61(6): p. 761-764.
4. Richie, J.P., Detection and treatment of testicular cancer.
CA Cancer J Clin, 1993. 43(3): p. 151-175.
Overview
A health objective that would target improvement of health of college men. For example an increase in education about testicular self exam, prostatitis and STD/HIV prevention, Violence and accident prevention, prevention of liver disease and heart disease, etc.
A health objective to target health education to International Students and to help them to learn about Western medicine and to seek out available medical services.
Submitted by: Mary Penney, MA CHES, Fashion Institute of Technology
Health Services, 7th Avenue at 27th Street, A-402 New York, N.Y.
10001-5992, e-mail address: Pennmae@sfitva.cc.fitsuny.edu
Objective 17-8 - Sun exposure
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other -
Baseline - %
Target: >/=75%
Recommendation: re-write to include students in higher education
as a select population.
Comment for Objective 17-8 - Sun exposure
Sun Exposure linked to self esteem, tanning booths, lack of eye protection, increase incidence of cataracts later in life. ok see in chp 17 but could include tanning salons or unprotected long term exposure. AKA sunburned more than 5 times during life time.
Greg German, past ACHA Chair, Consumer/Student Section, GREGORY.GERMAN@asu.edu
Objective 17-10 - Pap test
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other -
Baseline - >/=95% ever. 85% in preceding 3 years
Target: %
Recommendation: re-write to include students in higher education
as a select population.
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Overview
great time to inform College students [about diabetes]
Greg German, past ACHA Chair, Consumer/Student Section, GREGORY.GERMAN@asu.edu
Objective - ? None related ?
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other -
Baseline - %
Target: %
Recommendation: None.
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Objective 19-10a - Compliance with Americans with Disabilities
Act - Community-based health and fitness programs
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other - ACHA Health Promotion in Higher Education Task
Force (410) 859-1500 or http://www.acha.org
Baseline - %
Target: %
Recommendation: re-write to include students in higher education
as a select population.
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Objective 20-9 - Blood pressure monitoring
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other -
Baseline - Proxy data 68% at Cal Poly Pomona
Target: >/=95% checked in previous 2 years
Recommendation: re-write to include students in higher education
as a select population.
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Objective 20-12 - Blood cholesterol screening
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other -
Baseline - Proxy data 5% at Cal Poly Pomona
Target: >/=75% checked in previous 5 years
Recommendation: re-write to include students in higher education
as a select population.
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Comment for Chapter 21, page 5, paragraph starting on line 44 and CH. 21, page 7 Interventions and Disparities in Health of hard copy
Comment from Jim Rothenberger, MPH (University of Minnesota), at (612) 625-5692 or at rothenberger@epivax.epi.umn.edu for more information. Jim is Co-chair of the ACHA Task Force on Alcohol, Tobacco, and Other Drugs Task Force and co-author with Henry Buck, JD of the article "College Helath Needs to Participate in teh National STD Debate. J Am Coll. Health vol 47, Nov. 1998.
The increase in HIV/AIDS may well be in schools that accept
large numbers of economically disadvantaged students. I view the
change from gay to black/hispanic as an income shift more tha
a racial shift. We collect racial data but not income data on
cases. I do not think that a black male making $150,000 per year
is one bit more likely toacquire HIV than his white
neighbor making $150,000. Therefore schools with large numbers
of disadvantaged
students may need to be more concerned than their location would
suggest. for example
there is a college in Ladysmith, Wisconsin (not a big community)
that has a huge
enrolment of students from inner city Chicago.
We probably need to put more emphasis on STD's than HIV in college populations.We have documentation that STD's are markers for HIV exposure and actually increase the risk of HIV transmision if one partner is HIV+ and an STD is shared. One of the problems is that we tend to concentrate only on REPORTABLE STD's which misses a large share of the picture.
It would be reasonable to have a similar classroom education section for college students similar to the section for high school students. Unlike high school students, it would be nice if College Health Services had information available both for pt visits but also in outreach programs.
The big thing here is that we have to start to move away from only having objectives that measure changes in rates for REPORTABLE STD's. Syphilis and GC are not really important in college health, but Chlamydia is. However Herpes Simplex II and HPV are even mre important. Just because we can't treat with an antibiotic does not mean we shouldn't be tracking.
Objective 21-3 - Condom use at last intercourse
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 65
· ACHA - 35
· Other -
Baseline - 29.6%
Target: 46% at last intercourse
Recommendation: re-write to include students in higher education
as a select population.
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Overview: At-Risk Populations, page 22-5, lines 32-42
Comment from Karen A. Gordon, kagordon@Princeton.EDU
Include students in institutions of higher education as a target population for obtaining or completing series for vaccine-preventable diseases. The international student population does not arrive in the United States to attend school with completed immunization records.
Objective 22-5 - Reduce to zero cases per 100,000 hepatitis B rates in persons less than 25 years of age (except perinatal infections).
Recommendation: change the age grouping to 15-18 and 19-24 or 15-17, 18-24 in order to capture the population in higher education institutions.
Objective 22-21 through 22-24 - Immunization of children
and adults
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other -
Baseline - %
Target: %
Recommendation: re-write to include students in higher education
as a select population.
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Comment for Chapter 23, page 5, paragraph starting on line 33
Include college students - nearly half could still be considered adolescents. 11% of 18-24 year old college students seriously considered suicide based on data from the National College Health Risk Behavior Survey in 1995. Add words "college and universities" after "school on page 23-5, line 33 of hard copy.
Based on comment from Diane Fashinpaur RN, MSN, Director, Health
Services
The U of Akron. "Mechanisms for increasing awareness among
students about the nature of mood disorders (i.e. major depression,
anxiety) and the effect they can have on quality of life and performance.
Many times these illnesses are not readily recognized and therefore
go untreated. These disorders may be touched on in discussion
of substance abuse, but I feel that they need a platform of their
own. I am afraid that I don't have a suggestion for measurable
objectives at this time, but someone else out there may.
Objective 23-1 - Suicide
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 30, 31, 32
· ACHA - 19 (maybe add questions on planned and attempted
· Other -
Baseline - ??%
Target: %
Recommendation: add objective for "considering," "planning"
and "attempting suicide." And re-write to include students
in higher education as a select population.
Objective 23-2 - Injurious suicide attempts
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 33
· ACHA -
· Other -
Baseline: 0.4% (10.3% considered, 6.7% planned, 1.5% attempted)
Target: 1.8%
Recommendation: re-write to include students in higher education
as a select population.
Objective 23-2 - Developmental: Mental disorders among children
and adolescents (covers eating disorders)
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 73 through 78
· ACHA - 40, 41, 42
· Other -
Baseline - 30.8% dieted to lose weight, 53.6% exercised to lose
weight, 2.6% vomited or took laxatives to lose weight, 4.3% took
diet pills to lose weight
Target: %
Recommendation: re-write to include students in higher education
as a select population.
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Objective - ? None related ? add one for asthma education
at college health centers
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other -
Baseline - %
Target: %
Recommendation:
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Objective 25-1 through 25-6, 25-8 - Chlamydia, Gonorrhea,
etc.
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other - possibly ACHA DataShare
Baseline - %
Target: %
Recommendation: re-write to include students in higher education
as a select population.
Objectives 25-10, 25-12, 25-17 - Developmental objectives
for incidence, school-based clinics, screening
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other - possibly ACHA DataShare and Benchmarking Committee
Baseline - %
Target: %
Recommendation: re-write to include students in higher education
as a select population..
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Comment for Objective 26 - Adolescent use of illicit substance
Some ideas for rewriting the college health objectives to reflect
existing positive norms on campus include 1) emphasizing the %
students who do not binge drink in the objective, ie, "Increase
to 80% those students who report no binge drinking in the 30 days
before the survey" or 2) "Increase from 19% to 25% those
students who report abstaining from alcohol in the 30 days before
the survey."
The standard documentation available to measure these objectives can be found in the CORE Alcohol survey. As you know, the emphasis on problem behaviors in the Healthy People objectives may unintentionally serve to perpetuate the problems or inadvertently create "false norms." Focusing on the positive norms allows us to create strategies for primary prevention. I would appreciate your thoughts on these ideas.
Comment from Karen Zack Stein, RN,MS, CASAC, Nurse Health Educator Student Health Services P.O. Box 1923, Butler bldg. Niagara University, N.Y. 14109 (716)286-8386; Fax: 716-286-8391 kzs@niagara.edu
Coment for Objective 26 - Adolescent use of illicit substance
With regard to alcohol I would suggest other objectives such as reducing the number of ER visits due to alcohol poisoning, reducing the number of students killed or injured in DWI accidents, reducing the number of sexual assaults where and pregnancies where alcohol is a factor
Amelious Whyte, Coordinator, Chemical Health Programs, Boynton
Health Service, Assistant to the Vice President for Student Development
& Athletics, 410 Church Street SE #203
Minneapolis, MN 55455, 612-626-1145 (office) 612-625-2925 (fax),
awhyte@bhs.umn.edu
Objective 26-6, 26-6b, 26-6c - Adolescent use of illicit substance
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 47, 50, 55, 56
· ACHA - 27, 28, 29, 30
· Other -
Baseline - 2.4% other illegal drug use, 14.0% marijuana, 0.8%
cocaine
Target: 5.8%
Recommendation: combine select populations. Re-write to include
students in higher education as a select population.
Objective 26-7 and 26-7b - Binge drinking
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 44 (ask times binged in past 30 days)
· ACHA - 26 (asks times binged in past 2 weeks)
· Other -
Baseline - 35% in past 30 days
Target: 20% in past 2 weeks
Recommendation: re-write to include students in higher education
as a select population.
Objective 26-5c, 6, 6b, 6c, 7a, 8, 10, 11, 12, 14, 15a, 15b, 15c
Recommendation: include young adults (18-22) as a separate age category in the wording of the objectives. The CORE Alcohol and Drug survey (from U.S. DOE & Southern Illinois University) is a national survey that can also provide baseline data for these objectives.
Objective 26-8 - Riding with a driver who has been drinking
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 23 ride, 24 drive
· ACHA - 14 ride, 25 drive
· Other -
Baseline - 35.1% riding, 27.4% driving
Target: 30%
Recommendation: add this as an objective. And re-write to include
students in higher education as a select population.
Objective 26-14b - Perceptions of others drinking (perceived
drinks when partying or per week by typical student at your university)
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA - 25
· Other -
Baseline - Proxy data average perceived drinks per week by typical
Cal Poly student is 4.7 (average actual is 1.7)
Target: ??%
Recommenation: add this as an objective. And re-write to include
students in higher education as a select population. Contact Michael
Haines or Mary Hoban at ACHA 410-859-1500 for ACHA College Health
Assessment.
Send your comments for adding, changing or revising objectives; sources of data; baseline data; or targets to the Task Force at collhlth2010@csupomona.edu. Although the comments had to be in by December 15, 1998, there are opportunities to help DHHS fine tune the next draft.
Return to Top - Return to Table of Contents - Send Comment
December
15, 1998 by Jim Grizzell, jvgrizzell@csupomona.edu