NATIONAL COLLEGE HEALTH ASSESSMENT ACHA/NCHA II Saint Mary’s College of California Spring Semester Results 2014 DR. ALI- Welcome & organization of the presentation Food from Salsa Verde Restaurant in The order of this presentation will be as followed I’ll review the objectives and demographics of the NCHA 2014 survey, then share with you a synopsis of health related questions, then mental health related questions, and finally a slide on eating disorder prevalence Ms. Irene Umipig, our Health Educator and Program coordinator will share the results of the questions on alcohol, tobacco and other dugs Next Ms. Rachel Garcia, the Associate Director of the H&WC will go over the questions on relationships, dating violence, safety, sexual habits, and STI prevalence Dr. Evette Castillo Clark, the Dean of Students, will review the results of the customized questions related to Residential Experience Then Dr. Dai To, the Director of the Counseling and Psychological Services, will review the costumized questions on family history of mental health disorders, family history of alcoholism, and customized questions for graduate students’ use of CAPS and H&WC. Finally Mr. Greg Thomas, Director of Institutional Research, will share a brief review of the Graduate students’ survey and the customized questions they submitted for this survey.

National College Health Assessment National Research survey organized by the American College Health Association to assist institutions in collecting data about student habits, behaviors, and perceptions on the most prevalent health topics. ACHA 2014 The ACHA-NCHA survey was started in 2000, and revised in 2008 is the largest known annual comprehensive data collection on the health habits, behaviors and perceptions of college students. SMC has participated in the NCHA survey in 2007, 2009, 2011, 2014. Our plan is to participate in this survey every other year, so the next NCHA survey will be administered in spring of 2016………the fun never stops.

Objectives for ACHA Survey Identify the most common health and behavior risks affecting student’s academic performance Design evidence-base health promotion programs with targeted educational and environmental initiatives Create social norms marketing campaigns Impact the campus culture by opening a dialogue about health with students and staff Total n= 4257 140 schools, over 79,000 participants Even distribution between classes and demographic distribution mirrors our student population. The objectives of this survey are to ask health related questions and behavioral trends that puts the health of college students at risk and negatively impacts their academic success To design evidence based educational programs that meets the needs of this population To design marketing campaign that changes inaccurate perceptions and create new accurate and healthy social norms To better allocate the resources and services to the population at risk

PHYSICAL HEALTH

How would you describe your general health? 93% (91%) of college students surveyed their health as good, very good, or excellent Numbers found in the blue are national comparisons. Students consider themselves very healthy or in excellent health.

Health Markers Body Mass Index Exercise 2x increase students being underweight 6x prevalence in females underweight vs. males Over 30% of male students being overweight 9% of those overweight may be classified as obese 40% of SMC respondents don’t meet the recommended intensity and frequency for exercise each week 20% of respondents don’t do any exercise However when we look at some of the indices of health markers like body mass index and frequency of exercise we see a disconnect between the student’s perception of their health status and their actual state of health. Over the past 5 years of NCHA participation we note a 2X increase in the students that are under weight with the female students having a 6x prevalence of being underweight as compared to the male counterparts Over 30% of our students meet the definition of being over weight and 7% of the respondents meet the definition of obesity and 40% of the students don’t participate in adequate level of physical activity, and 20% of them don’t do any regular exercise

Physical Health Concerns Allergies Back pain Sinus Infections Asthma UTI Strep throat Migraine Fracture/Sprains Ear infection Irritable bowl The top 5 physical health problems that the students sought medical attention for has been consistently the same over the years. They are allergies, sinus infections, asthma, musculoskeletal injuries which includes sprain/ fractures and back pain, and UTI UTI frequency is over represented due to the female bias in our survey In the past we have had a higher rate of asthma and allergies in comparison to the national average but this year our numbers are close to the national average BUT what is consistent is that over 70% of the reported conditions that students sought the help of a medical professional and received treatment for were of the respiratory tract conditions.

Smoke Free SMC Initiative 70% of health related problems that students seek professional help for are respiratory related. This supports the need for a stronger smoke free policy for Saint Mary’s College. And this lends further support that a strong smoke Free/Tobacco Free policy will have a significant impact on the health and well being of our students. As Dr. Proctor of Stanford University puts it, nothing will have a larger positive health impact on the health and well being of a community than the adoption and implementation of a strong smoke Free campus policy.

Diagnosed Conditions: 12% of students reported having a physical disability Chronic illness, deafness, hearing, mobility, sight 15% of students reported having a learning disability Including ADD 6% of students reported having a psychological disability IR 2014- Cross tab for class, race, gender, highest education for mother and father Slight increase in students with physical health disabilities Consistent numbers in learning disablities 2x increase in psychological disabilities

Mental Health

Within the last 12 months, have any of the following affected your academic performance: Stress 30% Concern with Family/Friends 10% Anxiety 22% Internet/Computer Games 10% Sleep Difficulties 20% Cold/Flu 16% Relationships 9% Work 14% Roommate Issues 8% Extra Curricular Activities 14% Depression 11% As we can see mental health conditions of stress, anxiety and depression has the majority of the impact on the academic performance of the students and these numbers are consistently high over the past 5 years. Some of the trends we do note is that our number in internet and computer games /relationship difficulties/ work and financial strains is higher at SMC compared to the national average W also have a higher rates of cold and flu rate and room mate difficulties. I wonder if there is a relationship between the two as there may be an ideal number of square foot per student residence space

Mental Health Diagnosis by a Professional Insomnia/Sleep disorders Depression Attention Deficit Disorder Anxiety Obsessive Compulsive Disorder Substance Abuse There male students have 2-3X more sleep difficulties than female Addiction and substance abuse in almost 6X more among the male students but they are diagnosed and treated for anxiety and depression 2-3X less that females. It seems they self medicate more and that may contribute to the higher rate of poor outcome like suicide attempt. ADD and Substance Abuse higher, but not by much

% Happened in the Last 12 Months Mental Health Issues % Happened in the Last 12 Months SMC 2014 National 2014 Male Female Felt things were hopeless 44 52 40 Felt overwhelming anxiety 64 42 61 Felt overwhelming anger 43 41 35 Felt so depressed difficult to act 27 28 Attempted suicide 2.2 0.5 1.3 1.4 Seriously considered suicide 7 8 9 Intentionally cut, burned self 5 6 CHART- Self-harm, Suicidal ideation, Suicidal attempt

Affect on Academic Performance Eating Disorders Anorexia/Bulemia Affect on Academic Performance Diagnosis for anorexia and bulemia has increased since 2009, but numbers are still at national average of 3%. There are slightly more men (3.4%) than women (2.8%) reporting being diagnosed with anorexia/bulemia in 2014 3% of males report that they have experienced lower grades for an exam or a course due to an eating disorder. 2% of females report that they have experienced lower grades for an exam or significant disruption to their thesis The number of students that have been diagnosed with some type of eating disorder has not changed much over the years and remains in same at 1-1.5% but when asked about taking diet pills, vomiting or taking laxatives to lose weight, and excessive exercise to lose weight the numbers are higher specially for men in this category, highlighting the fact that male students are also struggling with their looks and body image issues Customized questions: restrictive eating, over exercising Within the last school year, % students reported eating disorders

Alcohol, Tobacco & Other Drugs ATOD Irene Umipig, Coordinator for Health Promotion & Education

Alcohol Binge Drinking Rates 18% of students don’t drink alcohol which is a drop from 23% in 2011 and lower than the national average of 21% Increase in binge drinking Females 5-6 drinks in one sitting Males 5-6 and 7 or more drinks in one sitting 4 or less drinks in one sitting 42% of SMC males (69%) 69% of SMC females (62%) This slide looks at binge drinking rates of the respondents from the survey. NCHA defines binge drinking as 4 or less drinks in one sitting. SMC students who participate in alcohol use, reported that 42% of our males and 69% of our females had 4 or LESS drinks in one sitting, therefore they did not partake in binge drinking behavior. This is higher than the national average of 40% males and 62% females. While we are at national average or lower for binge drinking– the high risk behavior is still very prevalent on our campus. There has been an increase in females drinking 5-6 drinks per sitting (15% to 22%) and in males drinking 5-6 (14%-21%) and 7 or more drinks (25%-37%) in one sitting. Our males are participating in a lot more heavy drinking than what we saw in 2011.

Social Norming.. Perception Vs. Reality Alcohol Perception- mid to high 90s Actual Use- f: 64% m: 73% Males above national average by 7% Marijuana Perception- mid 80s to high 90s Actual Use- f: 17% m: 30% Males above the national average by 6% This CHART focuses on Social Norms of PERCEPTION VS REALITY Perception for alcohol use remains high in the mid to high 90s, however actual use is relatively lower with our females at 64% and our males at 73%. That being said, our males are currently above the national average of alcohol use by 7%. Perception for marijuana also remains in the mid 80s to low 90s. However actual use is significantly lower with our females at 17% and our males at 30%. Again, our males are currently above the national average of marijuana use by another 6%. This shows the importance of campaigns like our Gaels Party Safe initiative which highlights social norms, and actual use while also role modeling the protective factors our students practice.

Alcohol and other Drugs Consequences of Drinking past 12 months Consequences of Drinking in the past 12 months SAINT MARY’S National 2014 Male Female Physically injured yourself 13 10 14 12 Physically injured another 2 1 3 Doing something latter regretted 28 26 29 30 Forgetting where they were 25 Getting in trouble with the police 6 4 Seriously considered suicide This CHART showcases Consequences attributed to drinking Forgetting where/what you did after drinking shows increases for both males and females compared to our 2011 numbers. Of these respondents a majority of female respondents came from our 2nd year class and a majority of our male respondents came from our 4th year class. Across the board, our male student respondents from our 4th year class were experiencing a majority of the consequences of drinking. Presumably, a majority of these students have now graduated…so who’s coming in second place? Male and female respondents from the 2nd year class. When looking at the responses for “seriously considered suicide” and “physically injured another person”, our 3rd year males are showing higher rates. The upperclassmen seem to take more risks in the amount of alcohol that they consume and they experience more of the consequences attributed to drinking. They may be the ones that are setting the trend for our incoming class and we need to make sure that they are more informed so they can practice more responsible behaviors.

Alcohol and other Drugs Protective Factors Leading Protective Factors Saint Mary’s National M F Use a designated driver 73 75 59 67 Stay with same group 71 58 68 Eat before and/or during drinking 61 66 57 63 Keep track of how many drinks 50 43 53 This CHART focuses on the Protective Factors practiced by our students who participate in drinking behaviors. Females show higher numbers compared to 2011 for most protective factors and Males also show a trend of higher numbers compared to 2011. The most prevalently used protective factor for males and females is making sure to have a designated driver. However, 2.5% of students who had 5 or more drinks still chose to get behind the wheel. And 18% of those who had any alcohol also did the same. Aside from having a DD, females show high numbers in “staying with the same group of friends” while males show high numbers in “eating before/or during drinking” 4th years are more likely to practice a majority of the protective factors, albeit one protective factor…1st years are more likely to choose not to drink

Relationships & Sexual Behavior Hi, I am Rachel Garcia the Associate Director in the Health and Wellness Center. I am going to first talk to you about our findings on Relationships and Sexual Behavior.

Abstinence Within the last 12 months, 37% of males and 35% of females have had 0 partners in oral sex, vaginal intercourse and anal intercourse. First, it is important to note our rates of Abstinence at Saint Mary’s College. As you see on the slide, within the last 12 months, 37% of males and 35% of females have had 0 partners in oral sex, vaginal intercourse and anal intercourse.

Contraception (of those that are sexually active) 6% decline in use of oral contraceptives IUD use has doubled since 2009 and we have higher rates than the national average Emergency contraceptive use has gone down from 21% in 2011 to 16% in 2014 Male Condom utilization is 3% below the national average Withdrawal method has gone down (26% female, 18% males) and we are below the national average Women reporting their actual use of contraception was significantly lower than the male perceptions regarding use of these methods As you can see on the slide, among our students who are sexually active: there has been a decline in the use of oral contraceptives. Usage of the IUD has doubled since 2009 and we have higher rates than the national average. Emergency Contraceptive use has decreased since 2011 and we are right in line with the national average. Also, our male condom utilization is below the national average. There are also 2 important findings in regards to male vs. female perception of contraceptive use: First, our rates of the withdrawal method have decreased from 2011. However, 26% of females are reporting using this method; while only 18% of males are reporting using this method. Showing that there is a disconnect between the two genders. Secondly, when asked about birth control methods including: birth control shots, implants, the cervical ring, the patch, IUD, female condom, diaphragm, cervical cap, and contraceptive sponge female numbers are lower than males. With men often reported almost double the usage of these methods in comparison to females. This shows another gap in perception vs. reality. The only time where men and women are reporting their contraceptive use similarly is condom use and oral contraceptive use.

Sexually Transmitted Infections Proportion of college students who reported being diagnosed or treated by a professional within the last 12 months: HIV 0.6 Genital Herpes 1.0 Gonorrhea 0.5 Hep B or C 0.6 Chlamydia 0.6 HPV 1.3 This chart shows the rates of sexually transmitted infections that students have been diagnosed or treated by a professional for within the last 12 months. All reported STI’s have increased since 2011 except: Hepatitis B or C has remained the same and Chlamydia has decreased. It is important to note that those who are reporting being diagnosed or treated for HIV has doubled since 2011. Also, those that are reporting being diagnosed or treated for Herpes has tripled since 2011. We are higher than the national average for all STI’s except Chlamydia. National: HIV = 0.2 Genital Herpes = 0.6 Gonorrhea = 0.3 Hep B or C = 0.3 Chlamydia = 1.2 HPV = 0.9

Sexual Behavior Oral Sex 6 7 5 Vaginal Intercourse 56 57 53 Sexual behavior and using a condom/protective barrier in the past 30 days: 2009 2011 2014 National 2014 Oral Sex 6 7 5 Vaginal Intercourse 56 57 53 Anal Intercourse 33 41 34 28 The only method to prevent STI transmission is using a condom or protective barrier. This chart shows the percentage of students using a condom or protective barrier during oral sex, vaginal intercourse, and anal intercourse. As you can see we are above the national average for condom use. However, the data shows that the highest rates of using a condom always during oral sex is for 4th year females (22%) and 1st year makes (15%) Those using a condom always with vaginal sex is highest for females during their first year and males during their 3rd year. Condom use for anal sex was highest for females in their 5th year and during the 3rd year for males. There was significant data showing that females who drank more often were more likely to have unprotected sex. This data is significant when determining what is causing our STI numbers to increase.

Violence & Physical Safety

Violence Within the last school year, SMC students reported experiencing: % 2009 2011 2014 National 2014 M F Physically assaulted 8 4 3 5 Involved in a physical fight 17 6 10 9 11 Verbally Threatened 37 16 26 15 25 12 33 66 It is important to note that our rates of violence for males are making a steady decline. This is seen in regards to males involved in physical fights, those and those that are physically assaulted or verbally threatened. As seen in the chart we are lower than the national average for all categories for our males. For females we continue to be right along with the national trend for those who were involved in a physical fight or were physically assaulted. However, we are significantly lower at 12%, compared to the national 66% for verbally threatened.

Domestic Violence Title IX Statistics % Incidence in the Last 12 Months SMC 2014 National 2014 Male Female Sexually touched without consent 3 8 4 10 Attempted penetration against their will 2 1 Sexually penetrated without consent 9 Stalking 7 A physically abusive intimate relationship An emotional abusive intimate relationship 5 6 11 A sexually abusive relationship Victims of stalking: 7% of 1st year females; 10% of 1st year males Emotionally abusive relationship: 12% of 3rd year females Physically abusive relationships: 2% of 2nd year females Sexually abusive relationships: females 3% in 2nd year; males 6% in 1st year As Irene mentioned the statistics for 1st year males in regards to being sexually touched without consent, having sexual penetration attempted without consent and sexual penetration without consent was consistently 6%. Here we also see the same 6% for 1st year males in regards to sexually abusive relationships.

Information on Campus Top 10 received information Alcohol/Drug Use Sexual Assault Stress Reduction Nutrition Cold/Flu/Sore Throat Physical Activity Depression/Anxiety Relationship Difficulties Violence Prevention Tobacco Use Top 10 information requested Stress Reduction Nutrition Sleep Difficulties Help others in Distress Physical Activity Depression/Anxiety Sexual Assault STD/STI Prevention Grief and Loss Relationship difficulties Received Information (Significant differences from 2011: Physical activity moved from 3 to 6 Stress Reduction moved from 6 to 3 There has been an increase in stress reduction programming from HWC, Residential Experience, and CAPS. STD/STI’s are off the list Relationship Difficulties moved from 10 to 8 Violence Prevention and Tobacco use are new to the list National vs. SMC: Pregnancy info received: SMC = 31% National = 46.5% STD/STI Prevention info received: SMC = 48% National 58% Would like info on pregnancy prevention: SMC = 46% National = 35%