Welcome to the Special Issue of the American Journal of Health Education (AJHE) on Health Education and Health Promotion in College Settings. For this Special Issue, AJHE received numerous high quality and publishable manuscripts. Accepted papers on this topic will appear in both this Issue of AJHE as well as Volume 48, No. 5, the September/October Issue of AJHE.
College represents a unique time in many Americans life and health. Traditionally, college students are emerging adults — no longer adolescents yet far from responsible adults. It is a critical developmental period that involves change and exploration. Key tasks in the transition to adulthood need to be accomplished, including taking responsibility for one’s own health. While many might assume that emerging adults are among the healthiest segments of the American population, they demonstrate a pattern of unhealthy behaviors related to diet, physical activity, sexual activity, tobacco, and alcohol. These health behaviors can have significant consequences for future health, including early development of chronic disease.
The AJHE has a focus on publishing research articles, feature articles, and commentary manuscripts that focus on chronic disease and related lifestyle behaviors across the lifespan. AJHE also emphasizes the need for Health Education to be grounded in Health Behavior Theory. As you peruse the manuscripts in this Special Issue, you will find papers on several chronic diseases and lifestyle behavior topics. These papers reveal the importance of Health Education and health promotion programs on college campuses and demonstrate the potential of health education and promotion in higher education to enhance health and improve learning outcomes. The health, safety, and well-being of the 20 million students enrolled in colleges and universities across the United States requires special attention and should be a priority. Inattention to their needs will be costly in the long run.
In this issue, four research articles, three commentaries and one feature article provide information that contribute to the understanding of college student health. The articles in this Special Issue address a number of significant issues including mental health, food insecurity, social justice, and recovery from substance abuse. These issues are important for several reasons which articulate with the American College Health Association’s Guiding Principles for Health Promotion in Higher Education. These guiding principles are:
“Health is the capacity of individuals and communities to reach their potential.” As you read the Background section of the Special Issue manuscript, you find discussion on how chronic disease prevention and health promotion in college age students is a springboard for health and well-being across the lifespan.
“The specific purpose of health promotion in higher education is to support student success.” The academic argument for chronic disease prevention and health promotion is evident in the Special Issue manuscripts. Quite simply, healthy students learn better, miss fewer classes, and tend to drop-out less than unhealthy students.
“IHE’s are communities.” Institutions of higher educations are learning communities that have a collective identity and have specific cultural and behavioral norms. Principles of the Social Ecological perspective on health promotion programs espoused by leading health educators published in the classic work of Ken McLeroy, Dan Bibeau, Alan Steckler, and Caren Glanz have relevance here. Health promotion works best on multiple levels including; intrapersonal, interpersonal, institutional, community and policy levels. You will find many studies in the Special Issue include Social Ecological perspectives.
“Health promotion professionals in higher education practice prevention.” Primary prevention is the cornerstone of health education and health promotion programs. The focus on prevention is clearly evident in the Responsibilities and Competencies for Certified Health Education Specialists published by the National Commission for Health Education Credentialing Inc.
“Health promotion in higher education is facilitating, rigorous, and inclusive.” We believe you will find as you read the articles in the special issue that rigor exist in both the interventions implemented to foster positive behavior and the research methodology to measure impact. The manuscripts highlight the need for inclusion and social justice in college health education and health promotion programs.
The commentary by Alyssa M. Lederer and Sara B. Oswalt sets the tone for the Special Issue on College Health. These authors offer three misconceptions about college health in general which articulate with the standards of practice for health promotion in higher education. Lederer and Oswalt make the argument that college students today are becoming a microcosm of American society with the same health related problems and lifestyles. Health promotion programs can help students and the community where they reside reach their potential. The authors also iterate the academic argument for Health Education and health promotion programs; healthy students are better learners and have better academic outcomes. The health of students is central to the academic mission of all universities.
Elise K. Eifert, Michael E. Hall, Sareen S. Gropper, & Melissa Kondor provide a concrete example of health promotion practice on a college campus in their commentary. They describe how faculty, staff, and administration worked together to bridge the academic-practice divide and bring quality health promotion to their college campus. Specifically, they reflect on the planning, implementing, and evaluating of activities for Healthy Campus 2020, an initiative initiated by the University President and Vice President of Student Affairs that utilized sub-committees consisting of members from various divisions of the university. Reflecting on their personal experience, the authors will remind academics and practitioners in health promotion that collaboration is the key to success.
Sonya Satinsky, Reonda L. Washingon, Jonathan Pastor, and A. Katherine Wagner discuss the significance of addressing high risk drinking behaviors on college campuses from a unique perspective- to prevent bias towards marginalized students by those under the influence of alcohol. This commentary addresses the fact that alcohol is frequently involved when crimes are committed against students who are of color, gender-nonconforming, LGBT, or female. Furthermore, they propose a model that outlines how high-risk drinking cultures like college campuses present a risk for chronic disease among marginalized students. They make a strong case for adding a social justice lens to interventions that attempt to address high risk drinking on college campuses.
The Feature Article by Eric T. Beeson, Jennifer M. Whitley, and Holly M. Peterson provides a state-of-the-art review of college recovery from substance abuse programs. The authors clearly link substance use disorder among college students to chronic disease and to academic performance while in college. The authors also highlight the need for a Social Ecological approach to addressing substance use disorders and subsequent recovery programs. The authors clearly outline individual, institutional, and community factors that influence substance use disorders and are possible factors to address in recovery programs.
The article by Valarie Senkowski, Paul Branscum, Sarah Maness, and Daniel Larson provides an excellent example of how research on college age population is becoming more theory driven. The authors applied the Integrative Model of Behavioral Prediction to drive their research design. The Integrative Model of Behavioral Prediction is a composite model incorporating key constructs of the Social Cognitive Theory, the Theory of Reasoned Action, and the Theory of Planned Behavior. The authors found that college students do not consume the proper amount of vegetables. Analysis of data by constructs of the Integrative Model of Behavioral Prediction are provided.
Food insecurity among college students is an often ignored concern. We assume college students have access to an adequate quantity and quality of food. Linda L. Knol, Cliff A. Robb, Erin M. McKinley, and Mary Wood provide one of the few studies of food insecurity among college students. The authors found that the percentage of students with food insecurity was higher than the national average. Information from this study will provide health educators with background information to design educational and community interventions in their population of interest.
The study by Kendra Guilford, Erin McKinley, and Lori Turner examines breast cancer knowledge, beliefs and behaviors of college women using the Health Belief Model. Although mammograms are not routinely prescribed until later in the life course, women in their 20s should begin breast self-exams. The authors found that breast cancer knowledge among college women was relatively low justifying the need for health education intervention for college age students. Further, the study found a need to enhance perceived susceptibility and perceived severity of breast cancer in the study population. The Guilford, McKinley, and Turner manuscript provides an excellent example of a theory driven research study.
Samantha R. Paige, Michael Stellefson, Beth H. Chaney, Don J. Chaney, Julia M. Alber, Chelsea Chappell, and Adam E. Barry explore the role of online social capital and electronic health (eHealth) literacy in chronic disease prevention among college students in their study. Specifically, the authors examine the moderating effect of Instagram on the relationship between eHealth literacy and two different types of social capital- bridging and bonding. The results have implications for how health education specialist on college campuses can use popular social networking sites for health promotion.
In closing, it is our hope that the articles included in this Special Issue will encourage new and sustain interest in the study of Health Education and health promotion in college settings. We hope that this compilation will generate future research and intervention development to address the health issues of college students across the United States.