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 opporuntities to help DHHS fine tune the next draft.
Chapter 4. Educational and Community Based Programs
Comment for 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.
Comment for 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
Comment for Chapter 4 and the entire draft.
I read the objectives and agree wholeheartedly that there should be more objectives addressing college health issues. This is a time when many students create habits that will follow them for the rest of their lives, and I'd like as many possible of those habits to be health-promoting.
While I do not have any specific items to include in those objectives, please consider this email indicative of my full support of such additions.
Renee Drellishak, MPH Manager of Health Promotion and Development Hall Health Primary Care Center University of Washington (206) 616-8476 reneedre@u.washington.edu
Comment for Chapter 4 and the entire draft.
First and foremost I join others who
suggest that there should be more
objectives related to college student in the Helathy People 2010.
With regard to the two that are currently
included, how is "receive
information" as in students must receive information from
their college
regarding all six priority health risk behavior areas, defined.
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
Comment for Chapter 4 page 5, paragraph starting on line 32 and Interventions and Disparities in Health of hard copy.
Change text of first line to say "through" instead of "to" university level. This would define "school" comprehensively and broadly instead of narrowly as generally thought of a elementary through high school.
Comment for Chapter 4 page 5, paragraph starting on line 48 and 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. 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.
Comment for Chapter 4 page 5, paragraph starting on line 48 and 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. 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 binge drinking/alcohl section talks about perceived norms and actual behavior. It would be interesting to do something similar for STD's and HIV.Here the problem is just the opposite of Haines, Perkins, et al. work with alcohol. The perception is that almost nobody has an STD or is HIV+ and the reality is that a greater number actually ARE STD+ or HIV+. It would be interesting to set up a research project to see if increasing the group perception also increases detection rates.
I think the greatest problem we have to face in STD and HIV is perception, just as it is in binge drinking. People think that HIV has gone away or is easily treatable. Somehow the issue needs to be kept in the forefront or condom use behavior will stop increasing.
Objectives 4-3 - Undergraduate health risk behavior information
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- question 96
· ACHA - 59
· Other
Baseline - 6%
6% received information on all six health risk
areas combined
- 22.5% received information
on injury prevention and safety
- 33.4% received information on violence prevention
- 17.6% received information on suicide prevention
- 26.8% received information on pregnancy prevention
- 43.4% received information on STD prevention
- 49.1% received information on HIV or AIDS prevention
- 27.8% received information on tobacco use prevention
- 49.2% received information on alcohol and other drug
use prevention
- 30.4% received information on dietary behaviors and
nutrition
- 35.9% received information on physical activity and
fitness
Target: 12% receive information on all six
health risk areas combined
Recommendation: include the individual items as listed above so
readers will see the specific amounts of information for each
topic covered in the major health risk areas.
Recommendation: This is one of only two objectives in the draft that address college health. The other is 26-7b on binge drinking. The six priority health risk areas are: behaviors that cause intentional and unintentional injury prevention; sexual behaviors; tobacco use; alcohol and other drug use; dietary patterns that cause disease; and inadequate physical activity. Include data on information received for each individual sub-topic area.
Objectives 4-3 - Undergraduate health risk behavior information
sic Probably for one of the six health risk behavior areas . . . "behaviors that cause unintentional and intentional injuries." I think it should say, "..... unintentional and intentional injuries or death." This would cover the education we do about seat belts (death from motor Vehicle accidents) or suicide attempts, etc.
Comment on behalf of a clinician from Patricia A. Irwin, RN, MSN Manager, Quality Improvement University Health Services Penn State University Phone: 814-863-2058 208 Ritenour FAX: 814-863-8464 University Park, PA 16801 Email: pai2@email.psu.edu
Objectives 4-3 - Undergraduate health risk behavior information
Comment from Bill Dixon, M.D. Staff Physician, Sonoma State University, Rohnert Park, CA
My concern is why the goal for exposure to vital health educ
info is only 12 percent for a college population. The documented
6 percent exposure seems abysmal, and for the future leaders of
our society, I think the goal should be 100 percent. There are
a few core areas of knowledge that any
active participant in life should explore, and healthy behavior
needs the same attention as English 1A and the other disciplines
sanctioned by universities.
I'm out of the closet on this issue, as a blatant supporter
for required "Life Information" (or health, happiness,
survival skills or whatever) courses in college. College students,
and older adults, continue to make non-healthy choices, very often
in the absence of any knowledge of what choices really exist.
I think we have an obligation to teach these important issues.
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Objective 15-1 -
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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Objective 6-6 - Food handling by consumers
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other -
Baseline - %
Target: 87% clean, 91% separate, 90% cook, 94% chill
Recommendation: re-write to include students in higher education
as a select population.
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Add to text on page 7-21 line 18 after "Poverty, discrimination," the words "hate and bias (prejudice)," . . . .
Based on comment from Luoluo Hong, (Louisiana State University) Chair, ACHA Campus Violence Task Force at (504) 388-1400, or at luoluo.hong@worldnet.att.net for more information.
. . . where are suicide and hate/bias-related crimes mentioned????
Objective 7-15 - Safety belts and child restraints
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 15, 16
· ACHA - 11, 12
· Other -
Baseline - 10.2% riding, 9.2% driving rarely or never use seatbelts
Target: 93% always use seatbelts
TWO Recommendation: re-write to include students in higher education
as a select population.. Re-write for positive % always used.
Objective 7-17 - Use of motorcycle helmets
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 17, 18
· ACHA -
· Other -
Baseline - 34% rarely or never wore
Target: 75%
Recommendation: re-write to include students in higher education
as a select population.
Objectives 7-26 & 7-27 - Use of bicycle helmets
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 19, 20
· ACHA - 13
· Other -
Baseline - 87.1% rarely or never wore
Target: 50% use
Recommendation: re-write to include students in higher education
as a select population.
Objective 7-36 and 7-37 - Forced sexual intercourse and (Developmental/Former 7.15) Reduce to less than __ percent the proportion of battered women and their children turned away from emergency housing due to lack of space
Comment from Luoluo Hong, (Louisiana State University) Chair, ACHA Campus Violence Task Force at (504) 388-1400, or at luoluo.hong@worldnet.att.net for more information.
. . . statistics target K-12, but what about COLLEGE STUDENTS? For example, the baseline rates of sexual assault/rape are much higher for college women than for other populations. Will this be addressed?
Luoluo Hong, PhD, MPH
Assistant Director for Wellness Education
Louisiana State University
Student Health Center, Room 250A
Baton Rouge, LA 70803
Ph: (225) 388-1400 or 388-5718
Fax: (225) 388-5655
Web Site: http://students.lsu.edu/shc
E-Mail: lhong@lsu.edu
"It is no longer a choice between violence and nonviolence in this world; it's nonviolence or nonexistance!" (Martin Luther King, Jr., 3 April 1968, Memphis, TN)
Visit the web site for Men Against Violence at LSU, http://www.geocities.com/CollegePark/Campus/7625
Objective 7-36 - Forced sexual intercourse
Comment from Luoluo Hong, (Louisiana State University) Chair, ACHA Campus Violence Task Force at (504) 388-1400, or at luoluo.hong@worldnet.att.net for more information.
First of all, nothing really new compared to the 2000 Objectives.
I would prefer to have the objectives read more to reflect the
agency of violent acts (that is, the problem is in the perpetration,
not in the victimization). I suppose this reflects more of a philosophical
issue. For example, Objective 7.36, Reduce the rate of forced
sexual intercourse or attempted forced sexual intercourse of persons
aged 12 and older to less than 0.55 per 1,000 persons reflects
changing the number of victims. I would prefer to have the objective
reworded to reflect a decrease in the number of perpetrators (e.g.,
Reduce the rate of forcing sexual intercourse or attempting to
force sexual intercourse to less than.....[whatever the data]).
This would be a different way of looking at
violence, I think.
Objective 7-36 - Forced sexual intercourse
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 69 or 71 but re-word for in the last 12 months
· ACHA - 18
· Other -
Baseline - ??%
Target: %
Recommendation: re-write to include students in higher education
as a select population. Add one to reduce number of perpetrators.
Objective 7-37 - (Developmental/Former 7.15) Reduce to less than __ percent the proportion of battered women and their children tuned awa from emergency housing due to lack of space
Comment from Luoluo Hong, (Louisiana State University) Chair, ACHA Campus Violence Task Force at (504) 388-1400, or at luoluo.hong@worldnet.att.net for more information.
First of all, nothing really new compared to the 2000 Objectives.
I would prefer to have the objectives read more to reflect the
agency of violent acts (that is, the problem is in the
perpetration, not in the victimization). I suppose this reflects
more of a philosophical issue. For example, Objective 7.37: Reduce
to less than___ percent the proportion of battered women and their
children turned away from emergency housing due to lack of space
is an important objective to keep. But I would also like to see
an objective such as, "Reduce to less than ___ percent the
proporion of batterers who do not receive treatment or intervention
service, etc. (or something like that). Ditto with all of the
objectives related to violence/abuse.
Objective 7-38 - Sexual assault other than rape
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. Add one to reduce number of perpetrators.
Objective 7-40 - Physical fighting
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 27, 28, 29
· ACHA - 17
· Other -
Baseline - 10.2%, 0.9% injured
Target: </=35% for grades 9 - 12
Note: re-write to include college students as a select population.
Objective 7-41 - Weapon carrying
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
- 25, 26
· ACHA - 16
· Other -
Baseline - 8.0% weapon, 2.9% gun
Target: %
Recommendation: re-write to include students in higher education
as a select population.
Healthy People 2000 Objective 9.19 to increase athletic
protective gear
Objective 7-?? - Use of Athletic Protective Gear (former Healthy
People 2000 Obj. 9-19
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 and include HP 2000 objective.
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Objective - ? None related ? -Developmental Objective
Recommendation: University hall resident assistants have to
dispose of hazardous waste(puke, urine, blood) yet are not OSHA
trained to handle infectious wastes. Could compromise college
student safety.
Therefore objective be for the 100,000 Resident assistant out
there, "% of Resident Assistants that need OSHA training
and do not posses it."
Greg German, past ACHA Chair, Consumer/Student Section, GREGORY.GERMAN@asu.edu
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Objective 9-14 - Adult use of oral health care system
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other -
Baseline - %
Target: >/=70% in past 12 months
Recommendation: re-write to include students in higher education
as a select population.
Objective 9-16 - Developmental: Community health centers
with direct oral health service component
Data Source
· 1995 National College Health Risk Behavior Survey (NCHRBS)
-
· ACHA -
· Other - ACHA Health Promotion in Higher Education Task
Force
Baseline - %
Target: %
Recommendation: contact ACHA, 410-859-1500 or http://www.acha.org
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 opporuntities 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