Student Health Services at Historically Black Colleges and Universities and Predominantly Black Institutions in the United States

Introduction

Student health services are associated with improved health outcomes and academic success, particularly among under-resourced college populations. This study compared student health services at Historically Black Colleges and Universities (HBCUs) and Predominantly Black Institutions (PBIs) and identified factors associated with the availability of comprehensive health services (CHS).

Methods

We conducted a secondary analysis of 2022 data from the Integrated Postsecondary Education Data System (IPEDS), the Minority Serving Institutions (MSIs) Directory, and the websites of HBCUs and PBIs (n=167). Bivariate and multivariate logistic regression analyses were undertaken to identify institutional variables associated with providing CHS. Institutional variables included college type (public vs. private), MSI category (HBCU vs. PBI), undergraduate enrollment, location, and proportion of Pell grant recipients.

Results

Approximately 13% of HBCUs and 26% of PBIs offered no student health services; 65% of HBCUs and 39% of PBIs offered on-campus CHS with prescribing providers. Four-year HBCUs were five times more likely than 4-year PBIs to have CHS (p=0.014). Institutions with more Pell Grant recipients were less likely to offer CHS.

Conclusions

Access to health care is an important social determinant of health, academic persistence, and achievement for college students. HBCUs were significantly more likely than PBIs to offer CHS. HBCUs are more likely than PBIs to have resources from federal funding, donors, and endowments that may support the development of student health centers and services. Increased funding for PBI health centers could improve access and promote health equity among the most vulnerable student populations.

College women with a disability and interpersonal violence: A call to action

ABSTRACT

Interpersonal violence is a serious public health issue, particularly in the young adult population. College women are more likely to experience interpersonal violence than the general population; college women with disabilities are at particularly high risk of victimization. Despite this reality, screening rates for interpersonal violence in college health centers remain low, and college women, both disabled and not, report unsatisfactory interactions with college health providers after an interpersonal violence experience. We provide suggestions for nurse practitioners working in college health which will assist them in their endeavors to screen college women, specifically college women with a disability, for interpersonal violence and to respond to the outcomes of those screenings using a trauma and disability-informed practice lens.

Vaping behaviour patterns and daily blood pressure and heart rate variation: a brief report

BACKGROUND

Vaping, the use of an electronic device to deliver a drug-infused aerosol has become an increasingly popular way to consume nicotine since its introduction to the market in the early 2000s. Despite the differences in consumption patterns relative to combustible tobacco, the impact of ad libitum nicotine vaping on cardiovascular response has not been thoroughly studied.

SUBJECT AND METHODS

This research was conducted on vapers (n = 17) and smokers (n = 14) who represent a subsample of a larger study that explored the relationship between nicotine use, activities of daily living and 24-hour cardiovascular response using Spacelabs ambulatory blood pressure monitors. These data were analysed via ANOVA models and t-tests using SPSS 25.0 for Macintosh.

RESULTS

Vapers consumed nicotine significantly more frequently than did smokers, at 48.2% and 18.1% of every 15-minute waking measurement, respectively (p = 0.000). The act of nicotine consumption, rather than the mode of delivery, was significantly associated with increases in systolic, diastolic, mean arterial pressure, and heart rate readings. There was no difference in the mean amplitude of response to nicotine between vapers and smokers.

CONCLUSIONS

This study's strong statistical findings, visually evident on ambulatory blood pressure monitor reports, demonstrated that ad libitum nicotine consumption has an acute, dose-dependent effect on cardiovascular response regardless of whether it is smoked or vaped. However, since vapers consumed nicotine more frequently, future studies should be conducted with larger sample sizes, and controlled for age and comorbidities to improve statistical strength.

IMPLICATIONS

This pilot study reveals that, when ad lib consumption is documented and measured, vaping has unique and potentially harmful effects on blood pressure, pulse, and mean arterial pressure. Because nicotine is consumed for much longer stretches, vapers have fewer rest periods between nicotine doses.

The impact of nursing assessment on cardiovascular health behaviour: a scoping review

BACKGROUND

Assessment represents a critical first opportunity for nurses to influence individual changes in health behaviour. As the global prevalence of cardiovascular disorders rises, so does the role of nurses in cardiovascular health promotion. This review applies Pender's Health Promotion Model (HPM) to an evaluation of the current research on the role of nursing assessment as an intervention to impact cardiovascular health.

METHODS

This scoping review was conducted using the PRISMA-ScR framework for scoping reviews. A search of electronic databases (CINAHL, psychINFO, Medline) resulted in 335 records, which were then screened for eligibility for inclusion using the criteria (a) English language, (b) publication between 2009 and 2019, and (c) nursing intervention studies. A total of ten articles met criteria and are included in this scoping review.

RESULTS

Half (n = 5) of the articles cited a theoretical framework. While none of the articles explicitly used the HPM, all involved measurement of HPM constructs: perceived benefits of action, perceived barriers to action, perceived self-efficacy, interpersonal influences, and situational influences. The focus and methodology of the included articles was heterogeneous. Assessment tools used were self-report surveys, biometric data, qualitative interviews, or a combination of these measures. Results were generally positive and indicated that nursing assessment is effective at altering health promotion behaviour and attitudes.

CONCLUSIONS

This scoping review demonstrated that the current body of literature on the impact of nursing assessment on cardiovascular health promotion behaviour is limited but consistent. Future research would benefit from thorough integration of the HPM into research design in order to more fully explain the causative mechanisms underlying behaviour change as a result of nursing assessment.

Should all patients with risk factors for ischemic heart disease receive aspirin?

Unstable angina appears to be caused by relatively brief, repetitive episodes of myocardial oxygen impairment secondary to platelet aggregation and dynamic vasoconstriction at sites of coronary stenosis and endothelial injury. With chronic endothelial injury, the accumulation of thromboxane A(2), serotonin, and other mediators may contribute to platelet aggregation and dynamic vasoconstriction. Aspirin acetylates the platelet enzyme, cyclooxygenase, thereby inhibiting the formation of thromboxane A(2). In certain patients with unstable angina, 1 to 4 aspirin tablets per day has proved beneficial in reducing the risk of myocardial infarction and death. Moreover, combining aspirin with a selected thrombolytic agent, such as streptokinase, appears to potentiate thrombolysis and further reduce mortality. Aspirin's toxicity to the gastrointestinal tract and its tendency to decrease vascular concentrations of prostacyclin, a local endothelial factor that hinders thrombogenesis and promotes endogenous vasodilation, are concerns when used in long-term treatment; for this reason, we do not recommend aspirin therapy for every patient with an acute coronary syndrome. We do, however, advocate such therapy for those with unstable angina and, in combination with selected thrombolytic interventions, for those with acute Q-wave myocardial infarctions in whom aspirin is not contraindicated.