Examining the Impact of Collegiate Setting Type on Student Utilization of STI and Reproductive Health Services: A Cross-Sectional Secondary Analysis of ACHA – National College Health Assessment III Data Restricted; Files Only

Odinjor, Quincy (Summer 2024)

Permanent URL: https://etd.library.emory.edu/concern/etds/n296x0783?locale=de
Published

Abstract

Background

Campus health clinics provide necessary sexual and reproductive health services (SRHS) to students. There is documented heterogeneity in services offered on campuses, but less is known about the influence of campus location and features such as institution type and religious affiliation on SRHS service utilization. We investigate the potential relationship between campus setting, identity, and student utilization of campus health services for SRHS.

Methods

The cross-sectional National College Health Assessment Wave III (Fall 2019 – Spring 2023) was analyzed using bivariate statistics in STATA SE V.17 to determine the relationship between campus setting and SRHS service utilization. Campus setting was defined by the population density around the campus, college religious affiliation was if the college was religious or secular, and SRHS utilization was any reported visits for gynecological or STI testing within the past year.

Results

Respondents (N=225,597) were largely undergraduates (77%) with most being 18-21 years old (60%). Out of all respondents, 52% had a reproductive visit within the last 12 months and majority of them came from Suburban students (30%). Rural students had a 10% significantly lower odds of having a reproductive visit at their campus health center compared to suburban students. Students who attended 2-year institutions had 40% significantly lower odds of having a reproductive visit at their campus health centers. Students who attended religiously affiliated schools reported 27% significantly lower odds of having a reproductive health visit at their campus health center compared to students at secular institutions. 

Conclusion

There is an association between campus setting and SRHS utilization. Rural and urban students were less likely to seek reproductive health services from their campus health centers compared to their suburban counterparts. Additional features such as institution type (2-year, 4-year) and college religious affiliation had strong influences on SRHS utilization. Future research should further investigate how student insurance status impacts how a student would seek health services and student preferences when seeking SRHS care.

Table of Contents

Chapter 1: Introduction ............................................................................................1

Chapter 2: Literature Review ...................................................................................4

 Importance of Sexual and Reproductive Healthcare Access in College Students..................4

Knowledge of Sexual and Reproductive Health Services in College Students........................6

Factors in Sexual and Reproductive Health Service Utilization among College Students.......7

Collegiate Campus Setting Factors...................................................................................9

Chapter 3: Methods.....................................................................................................11

Data Source.....................................................................................................................11

Study Design....................................................................................................................13

Sample.............................................................................................................................13

Study Measures..............................................................................................................14

Statistical Analysis............................................................................................................15

Chapter 4: Results .......................................................................................................17

Demographics ..................................................................................................................17

Analysis ............................................................................................................................20

Chapter 5: Discussion and Public Health Implications .............................................27

Campus Characteristics......................................................................................................28

Student Demographics........................................................................................................29

Limitations.........................................................................................................................31

Public Health Implications..................................................................................................32

Chapter 6: Conclusion....................................................................................................34

References.......................................................................................................................36

Appendices......................................................................................................................43

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