Healthy Campus 2010: midcourse review.
Abstract: Reviewing population-based assessments of health status, needs and assets of students and evaluating health improvement initiatives based on measurable goals and objectives is an effective practice and is required to create healthy campus communities and enhance academic performance. Healthy People 2010 (HP 2010) conducted a midcourse review, and in following the HP 2010 example, we conducted a midcourse review of over 170 objectives for this Healthy Campus 2010 midcourse review. The American College Health Association --National College Health Assessment (ACHA-NCHA) data from 455, 732 college students at over 389 institutions of higher education, plus data from the National Institutes on Drug Abuse: Monitoring the Future (2006) survey, was used for this research study. These two data sets were used because there are no other data sets on the college age population. The authors calculated progress quotients to determine percent of target achieved for 87 objectives. This article describes progress toward achieving Healthy Campus 2010 goals and objectives as found in Healthy Campus 2010: Making It Happen (ACHA, 2000). The article lists related initiatives and explains the midcourse review process, how objectives were selected, and how targets were determined. The focus of this article is on progress quotients and percent of targets achieved for over 80 objectives from 16 of the 28 Healthy People 2010 focus areas (United State Department of Health and Human Services, 2001). Additionally, two sets of objectives were developed as key indicators of student health and academic performance. These included the top 10 for each of the following: health impediments, and medical and mental health. Results indicate that 6% of the objectives and sub-objectives met or exceeded the target, 37% moved toward the targets, 10% remained the same and 43% moved away from the targets, and 5% did not have data allowing calculations. The information presented in this article can be used by college health professionals in their development of community based interventions that can be targeted and tailored to the individual. The Healthy Campus 2010 midcourse review expands the understanding of the trends and health improvement initiatives.
Subject: Universities and colleges (Usage)
Authors: Burwell, Cynthia
Dewald, Lori
Grizzell, Jim
Pub Date: 03/22/2010
Publication: Name: American Journal of Health Studies Publisher: American Journal of Health Studies Audience: Professional Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 American Journal of Health Studies ISSN: 1090-0500
Issue: Date: Spring, 2010 Source Volume: 25 Source Issue: 2
Topic: NamedWork: Healthy People 2010 (Report)
Product: Product Code: 8220000 Colleges & Universities NAICS Code: 61131 Colleges, Universities, and Professional Schools SIC Code: 8221 Colleges and universities
Organization: Government Agency: United States. Department of Health and Human Services Organization: American College Health Association
Accession Number: 308741501
Full Text: HEALTHY CAMPUS 2010

Healthy Campus 2010 provided a vision for achieving improved health for all students at institutions of higher education. Healthy Campus 2010 identified a set of 10-year health objectives to achieve during the first decade of the 21st century. It had two overarching goals--to increase quality and years of healthy life and to eliminate health disparities. These goals are supported by specific objectives in 17 of 28 Healthy People 2010 focus areas. Healthy Campus 2010 builds on initiatives pursued over the past decade. Initiated in 1990 with the publication of Healthy Campus 2000, Healthy Campus 2010 continues a management-by-objective planning process. Through Healthy Campus 2010, the American College Health Association (ACHA) sets forth objectives addressing improvements in health status, risk reduction, public and professional awareness of prevention, delivery of health services, protective measures, surveillance, and evaluation, expressed in terms of measurable targets to be achieved by the year 2010. Like its predecessors, Healthy Campus 2010 was developed through a consultative process, makes use of the best scientific knowledge available, and is designed to measure progress over time. Full achievement of the goals and objectives of Healthy Campus 2010 depends on a health system reaching all students, faculty and staff and integrating personal health care and population-based public health. The vision of healthy students in healthy communities involves broad-based prevention efforts and moves beyond what happens in physicians' offices, clinics, and hospitals--beyond the traditional medical care system--to the neighborhoods, schools, campuses, workplaces, and families in which people live their daily lives. These are the environments in which a large portion of prevention occurs. The 28 focus areas of Healthy People 2010 were developed by the lead Federal agencies with the most relevant scientific expertise. The focus areas had objectives relevant to college students, just like Park, Brindis, Chang, and Irwin (2008) did with their midcourse review of adolescents and young adults. The development process was informed by the Healthy Campus 2010 Task Force--a group of clinical health educators at more than 15 institutions of higher education. We have followed the Healthy People 2010 writing style in alternating between percentages and data per 1,000 or 10,000 persons.

METHODS

HEALTHY CAMPUS 2010 MIDCOURSE REVIEW

The midcourse review assessed the status of the national college health objectives. The midcourse review was the process through which the ACHA assessed the data trends from years 2000 through 2007, considered new science, available data, and recommended changes to ensure that Healthy People 2010 remains current, accurate, and relevant, while concurrently assessing emerging college health priorities. The midcourse review uses data made available from the American College Health Association's National College Health Assessment (ACHA-NCHA) and the National Institutes on Drug Abuse: Monitoring the Future (2006). These two data sets were used because there are no other data sets on the college age population.

MEASURING HEALTHY CAMPUS 2010 PROGRESS

Data Sources

A critical part of Healthy Campus 2010 was measuring progress toward the targets for the future year of 2010. The compilation and management of current college health data are central to assessing and implementing the national college disease prevention and health promotion goals and objectives. The data source for nearly all the objectives for this article is the ACHA-NCHA. In 1998 the ACHA initiated a work group to develop the ACHA-NCHA, a survey instrument designed to collect information on a broad range of student health behaviors, indicators, and perceptions. The development of the ACHA-NCHA has been described in a previous article (ACHA, 2008a). From its inception in Spring 2000 through the Spring 2007 survey implementation, the ACHA-NCHA has been used to collect data from 455,732 college students at 389 institutions of higher education. Reliability and validity analyses of the ACHA-NCHA are described in a previous article (ACHA, 2008a) and in an ACHA report (ACHA, 2004) several other data sources were used for comparison.

INITIATIVES RELATED TO HEALTHY CAMPUS 2010

Healthy Campus 2010 has ties to two other important documents distributed by the ACHA: Standards of Practice for Health Promotion in Higher Education (ACHA, 2005) and Hiring Guidelines for Health Promotion Professionals in Higher Education (ACHA, 2008b). Standard 5 of ACHA's Standards of Practice (ACHA, 2005) suggests that effective practice of college health requires practitioners to understand and apply evidence-based approaches. These approaches review data gathered from published research on campus, local, state, and national health priorities; conduct population-based assessments of health status, needs, and assets of students' conduct environmental assessments of campus community health needs and resources; develop measurable goals and objectives for health promotion initiatives; evaluate health promotion initiatives using valid and reliable quantitative and qualitative approaches; report evaluation data and research results to students, faculty, staff, and campus community. The Hiring Guidelines suggest that college health professionals conduct needs assessments of the population and campus community; set measurable program objectives; use theories and models of health promotion; implement evidence-based programs; assess and evaluate programs for student learning outcomes, individual health status and behavior changes, and community health and change.

CALCULATIONS

Progress toward the target for each objective in Healthy Campus 2010 was measured using the progress quotient, or percent of targeted change achieved. This was the method used for the midcourse review of Healthy People 2010. The progress quotient expresses any change from the baseline relative to the initial difference between the baseline and the target. The progress quotient also was used to monitor progress in Healthy People 2010. Baseline data values were published at the beginning of the decade for Healthy Campus 2010 objectives and sub-objectives for which data were available.

PROGRESS QUOTIENT

The progress quotient (PQ) measures the percent of the targeted change that was achieved. It is a relative measure because it expresses any change between the baseline and the most recent value as a percent of the difference between the baseline and the 2010 target. Targets for Healthy People and Healthy Campus 2010 have been set so that there is an improvement for all racial/ethnic segments of the population (that is, the targets are set "better than the best" racial/ethnic subgroup shown for the objective). This method uses the proportion of an ethnic group with the best health status or health behavior. For example, the target for objective 27-1/2a is to reduce cigarette smoking in the last 30 days from a 25% in 2000 to 10.5% in 2010. The ethnic/race group with the lowest proportion was Black students with 12% smoking. The target was set for a 15% improvement (better than the best). The comparability of the PQ does not depend on whether the measure is expressed in terms of adverse or positive outcomes. The formula for the PQ (United States Department of Health and Human Services, 2007) is as follows:

1. Progress Quotient Calculation

Percent o f target change achieved = ([Most recent value - baseline value]/Year 2010 target - baseline value]) x 100

PQ = (most recent value - baseline value)/(year 2010 target - baseline value) x 100

For example, the educational and community-based objective 7-3a calls for an increase in the proportion of students that received, from their university, health information on 11 critical health topics (physical activity, dietary behaviors/nutrition, STDs, AIDS/HIV, violence prevention, sexual assault/relationship violence prevention, AOD abuse prevention, pregnancy prevention, suicide prevention, injury prevention, tobacco use prevention) from a baseline of 3 percent in 2000 to a target of 17 percent in 2010. In 2000, 3 percent of students could recall receiving information on all topics. With the use of the formula above, 2 percent of the difference between the baseline and the 2010 target had been achieved in 2007.

PQ = (2.9 - 3.1)/(17.4 - 3.1) x 100 = -1.7 percent

For the population-based objectives, the PQ also can be used to measure progress toward the target for each population group with data beyond the baseline. For example, the PQ for objective 13-6a-2 to increase condom use by sexually active males at last intercourse in HC 2010 can be computed for the total population between the 2000 baseline (44) and 2007 (52). When the formula above is applied, 32% of the difference between the baseline and the 2010 target had been achieved for the sexually active male population in 2007.

PQ = (52 - 44)/(70 - 44) x 100 = 32 percent

In contrast, among college students, the proportion of college students who were obese increased from 8% at the baseline in 2000 to 11% in 2007. With the formula above, 51 percent of the difference between the baseline and the year 2010 target had been achieved in 2007.

PQ = (11 - 8)/(3 - 8) x 100 = -51 percent

In this example, the PQ indicates that the target was moved away from the target by a negative 51 percent of the difference between the baseline and the target. The PQ is positive when the rate moved toward the target and negative when the rate moved away from the target. The PQ can be used to compare progress for one objective, relative to its baseline, with progress for other objectives, relative to their baselines.

2. Defining Progress

* Met or exceeded target

** 100% or greater (positive percent)

* Movement toward target

** > 0% to 99% of targeted change

* Moved away from target

** Negative percent (i.e., -60%)

RESULTS

GOAL 1: INCREASE QUALITY AND YEARS OF HEALTHY LIFE

Healthy Campus 2010: Making It Happen highlighted the importance of increasing and maximizing both years and quality of healthy life. Progress toward this goal is currently assessed by measuring students' description of general health. The assessments result in the following conclusions:

* The proportion of students' describing their general health as good, very good, or excellent remained essentially the same showing a 1% decrease. The proportion of students describing their general health as excellent decreased from 18.9% to 15.9%. This was over double the percentage point change of any other general health category. EURIE GOAL 2: ELIMINATE HEALTH DISPARITIES

The second goal of Healthy Campus 2010 stems from the observation that there are substantial disparities among populations in specific measures of health, life expectancy, and quality of life. The second goal is to eliminate health disparities that occur by race and ethnicity, gender, education, income, geographic location, disability status, or sexual orientation. Detailed midcourse review of health disparities is beyond the scope of this article. There are, however, significant differences which will be described more thoroughly in a future article. Goal 1: Quality of Life in relation to disparities by ethnicity is provided to give an overall sense of disparities. The proportion of women describing themselves at good or better continues to be below males. The proportion of ethnic groups describing themselves at good or better continues to be about 5 percentage points below White students.

HEALTH IMPEDIMENTS TO ACADEMIC PERFORMANCE

Nine of the top ten health impediments to academic performance moved away from the targets. The mental health areas of stress, sleep difficulties, and depression affected 29%, 21% and 11% of students' academics in 2000, respectively. The proportions were 34%, 26% and 16%, respectively, in 2007. The targets were 25%, 16% and 7.5%. Use of the internet and computer games adversely affected 9% in 2000 and increased to 16% and the target was 6%.

MEDICAL HEALTH PROBLEMS

Seven of the top 10 medical problems from ACHA-NCHA question 44 moved away from the target. Back pain remained at about 46% each year. Allergies were indicated as a medical problem by about 42% of students in 2000 and moved to 47% in 2007. Anxiety made the greatest movement away from the target, going from affecting 7% of students to 13% of students.

ACCESS TO QUALITY HEALTH CARE

In 2000 the baseline was 83.3% of students having health insurance. By 2007 the proportion increased to 86.1%. The target is 100%, the same as that for Healthy People 2010. The proportion of students in the Asian, Black, Hispanic and Alaska Native/American Indian having insurance was 4 to 13 percentage points lower than that of White students. Each ethnic group, however, had improvements. The proportion of women having insurance remained about 3% above that of men.

CANCER

Use of sunscreen had a 2000 baseline of 14.7%. The target is 23.9% and each ethnic group increased approximately four percentage points with the overall 2007 increasing to 18.1%. The baseline for women having had routine gynecological exams in the past year was 63.1%. The proportions have a decreasing trend to 59% in 2007. Asian Pacific Islander women had some fluctuations but generally stayed at approximately 38%. The other ethnic groups trended a few percentage points below White students.

DIABETES

To measure prevention of diabetes program effectiveness and reduce the burden of diabetes baselines for "diagnosis of diabetes in the last year" and "ever having been diagnosed" were 8.4 and 9.2 per 1000. Targets were set at 2.5 and 2.2 per 1,000. Each of these moved away from the targets and 9.7 and 9.6 per 1000 in 2007. The baseline for asthma as a chronic disease affecting academic performance was 1,400 per 10,000 students. The target is 1,190 per 10,000 and 2007 data was 2,439 per 10,000.

HEALTH LITERACY

Objective 7.3b is an adaptation of the one from Healthy People 2010 objective 7.3 which used data from the 1995 National College Health Risk Behavior Survey (CHRBS). This found that 6% of students received information on all six topics. Additionally, 23% of undergraduate students reported receiving information on unintentional injuries, 38% on intentional injuries, 49% on alcohol and other drug use, 55% on unintended pregnancy, HIV/AIDS, and STD infection; 30% on unhealthy dietary patterns; and 36% on inadequate physical activity. This survey has not been conducted again.

ACHA-NCHA data show mixed results for 11 topic areas. The baseline for receipt of information on all topics was 3.1 with a target of 17.4%. The 2007 data indicate a movement away from the target to 2.9%. Six of the ACHA-NCHA topics are similar to the CHRBS. The target for each of the 11 topic areas is 55%. Receipt of information on injury prevention moved toward the target from 13.9% to 14.4%, from 47.5% to 49.3% on alcohol and other drug use, 33.3% to 37.5% for physical activity and fitness. Receipt of information moved away from the target for 55% on pregnancy prevention from 29% to 22.6%, from 39.8% to 28.7% for HIV/AIDS, and 32.5% to 31.3% for dietary behaviors and nutrition. STD information moved away from the target from 42.3% to 36.4%. New topics available from the ACHA-NCHA were sexual assault and relationship violence prevention (from 42.5% to 43.9%), violence prevention (from 18.3% to 21.1%) and suicide prevention (from 12.2% to15.3%).

FAMILY PLANNING

The four objectives for the Family Planning Focus Areas have moved toward the targets or were achieved. The baseline for sexually active females who used at least one contraceptive method at last intercourse was 88.4%. The target is 100%. The appropriate use of emergency contraception by sexually active women moved from a baseline of 6.7% to 10% which was the target. Unintentional pregnancy caused by both men and women nearly met or did achieve their targets of 17.5 per 1,000. Baselines and targets for women and men, respectively, were 25.3% and 23.9%, and 16.5% and 17.3%.

HEART DISEASE AND STROKE

The two objectives for this Focus Area each changed slightly and moved away from the targets. Blood pressure checked in the past 2 years moved from 90.1% to 88.5% and the target is 95.3%. Having cholesterol checked in the past 5 years decreased from 45.2% to 44.7% and the target is 62%.

HIV

Each objective in the HIV Focus area was to increase condom use among sexually active students. Condom use at last oral, vaginal, and anal intercourse by both genders in each ethnic group moved toward their targets. The proportion of sexually active females and males who used condoms at last oral intercourse moved from baselines of 2.2% and 3.4% to 3.4% and 4.1% respectively. Targets are 15%. The proportion of sexually active females and males who used condoms at last vaginal intercourse moved from baselines of 37.6% and 44% to 44% and 52.3% respectively. Targets are 70% for females and males. The proportion of sexually active females and males who used condoms at last anal intercourse moved from baselines of 16.2% and 35.5% to 21.4% and 39.7% respectively. Targets are 70% for both females and males.

IMMUNIZATION AND INFECTIOUS DISEASE

Fewer students indicated they had been diagnosed with Hepatitis B or C in the last year. As a result, 30% of the target was achieved. The rate moved from a baseline of 443 to 321 per 100,000. The target for objective 14-3/9 is 49 per 100,000.

INJURY AND VIOLENCE PREVENTION

Thirteen objectives were selected for reduction of injury and violence. Four objectives address seatbelt and helmet use. Four address sexual violence. The remaining objectives address homicides assaults and weapon carrying. Seatbelt use reached 78% and moved toward the target by 34%. The baseline was 70% and the target is 94%. Helmet use by students riding motorcycles reached 71%, moving 97% toward the target of 72% from a baseline of 51%. Helmet use by students riding bicycles reached 71%, moving 66% toward the target of 72% from a baseline of 51%. Helmet use by students riding motorcycles reached 71%, moving nearly 95% toward the target of 72% from a baseline of 51%. Physical assaults reached 23.7 per 1,000 and moved toward the target by 23.7 per 1,000. The baseline was 23 per 1,000 and the target is 18.6 per 1,000. Three of the four relationship violence objectives (assault by partner, sexually abusive, unwanted touching) moved toward their targets while the emotionally abusive objective moved 40% away from the target. Physical assaults and fighting each moved away from their targets by nearly 40%.

MENTAL HEALTH AND MENTAL DISORDERS

Attempted suicide had no change from the baseline and remained at 1.5%. Students having depression that was diagnosed and in treatment moved toward that target by 44%. The baseline was 34.9% and the target is 50%.

NUTRITION AND OVERWEIGHT

All of the nutrition and overweight objectives moved away from the targets. The largest movement away from the target was for the proportion of students in the healthy weight BMI ranges of 18.5 to 24.9. The baseline was 65.2% and target was 75%. The 2007 proportion was 62.4% for a 54% movement away from the target. Obesity had the next largest movement away from the target and was 51%. The proportion of students eating 5 or more servings of fruits and vegetables moved away from the target by 4%.

ORAL HEALTH

Having had a dental exam in the past year moved away from the target by 5%.

PHYSICAL ACTIVITY AND FITNESS

Physical activity objectives for exercise and strength training moved toward the targets. The baseline for endurance exercise was 40.3% and target was 55%. The midcourse review percent was 42.7% for a 16% movement toward the target. Strength training had a baseline of 47.2% and target of 65%. The 2007 percent was 48.2% resulting in a 6% movement toward the target. Bicycling moved away from the target by over 40% from a baseline of 52.7%.

PUBLIC HEALTH INFRASTRUCTURE

The ACHA-NCHA covers all key population groups by ethnicity, gender, and age. The American College Health Association publishes a reference group report of data consistently in the Spring of each year. Therefore, these objectives have been achieved.

ASTHMA

The proportion of students with asthma who indicated having received a low grade due to a chronic condition moved away from the target. The baseline was 581 per 10,000 and the target was 387 per 10,000. The 2007 proportion was 761 per 10,000 resulting in a 48% movement away from the target.

SEXUALLY TRANSMITTED DISEASES

The objective for HPV had a large movement away from the target while other objectives either remained the same (genital herpes, chlamydia for men) or moved toward the target. Chlamydia for women, gonorrhea, and pelvic inflammatory disease moved toward the targets by 20% to 50%. HPV's baseline was 1.35% and the target was 0.5%. The 2007 percent was 2.5% giving a 122% movement away from the target.

SUBSTANCE ABUSE

Two of three objectives related to consequences of substance use moved toward the targets. Substance use, however, moved away from the targets for all students. Driving after drinking and fighting due to alcohol use moved toward the targets by approximately 40% to 45%. The consequence of having injured himself or herself moved away from the target by 20%. Marijuana use moved away from the target by 12%. Higher risk drinking had no change based on Healthy People 2010 Midcourse Review (ACHA, 2008b) which used the Monitoring the Future studies (Johnson, O'Malley, Bachman, & Schulenberg, 2006). The baseline and midcourse percents were each 39%. The Healthy People 2010 target is 20%. ACHA-NCHA data indicated movement away from the targets for males and females. Women moved 39% away from the target while men moved 10% away from the target.

TOBACCO USE

Each of the three objectives moved toward their targets. Cigarette use moved 45% toward the target of 10.5%. The baseline was 25% and the 2007 percent was 18.5%. Smokeless tobacco moved from 3.7% to 3.5% for a 7% movement toward the 1% target. Cigar use moved from 5.7% to 5.6% for a 3% movement toward the 2% target.

DISCUSSION

Healthy Campus 2010 can be assessed in terms of its specific objectives and its overarching goals and this is what we have described in this research project. The review of the goals and objectives shows progress in quotients, and percents of targets achieved for over half of the 160 objectives and sub-objectives from 16 of the 28 Healthy People 2010 focus areas that related to college students and that were included in the Healthy Campus 2010 document. Greater numbers of objectives and sub-objectives are moving away from the target than are moving toward the target.

The HC 2010 Midcourse Review used the process of assessing the status of the national college health objectives. The review was done using data from the ACHA-NCHA and other national sources. Until the development and implementation of the ACHA-NCHA, it was very difficult finding data sources that were strictly dedicated to the college student population. The HC 2010 Midcourse Review data showed that 6% of the objectives and sub-objectives have met or exceeded the targets; 37% moved toward the targets, 10% had no change, 43% moved away from the targets; and 5% did not have data allowing calculations. Table 1 represents the percent of target achieved for focus areas 1, 2, 5, 7, 9, 12, and 13. Table 2 represents the percent of target achieved for focus areas 14, 15, 18, 19, and 21. Table 3 represents the percent of target achieved for focus areas 22, 23, 24, 25, 26, and 27.

Healthy Campus 2010: Making It Happen (ACHA, 2002) highlighted the importance of increasing and maximizing both years and quality of healthy life. The first goal of Healthy Campus 2010 is to help students of all ages increase quality and years of healthy life. To assess progress toward this goal the measurement of students' descriptions of their general health was used. A review of the data reveals that quality of life--measured in terms of general health remained essentially the same with a 1% decrease. The proportion of students describing their general health as "excellent" decreased from 18.9% to 15.9%. This was over double the percentage point change of any other general health category.

The second goal of Healthy Campus 2010 stems from the observation that there are substantial disparities among populations in specific measures of health and health status. The second goal is to eliminate health disparities that occur by gender and race and ethnicity. Goal 1: Quality of Life in relation to disparities by ethnicity is provided to give an overall sense of disparities. The proportion of women describing themselves at good or better continues to be below males and has decreased. The proportion of ethnic groups describing themselves at good or better continues to be about 5 percentage points below White students. The second goal of Healthy Campus 2010 calls for eliminating disparities among segments of the population. While there have been little or no change in rates for most of the populations associated with the social and demographic characteristics included in Goal 2, there is little evidence of systematic reductions in disparity. Although this article did not specifically address this goal there are significant differences remaining in health disparities that will be discussed in a subsequent article. Use of this large quantity of information can be very helpful for planning programs that will eliminate racial, ethnic, and gender disparities. A challenge in this area lies in the number of students with ethnic differences or from different minority groups who have taken the ACHA-NCHA survey. However, the lack of data on determinants of health such as campus and campus-community policies; living, learning, playing and working conditions; social, family and community networks; and income, socioeconomic factors for many Healthy Campus 2010 objectives limits the ability to plan programs to eliminate disparities.

The HC 2010 midcourse review provides access to current data trends, encourages the consideration of new science and available data for effective and forward movement. The midcourse adjustments and recommendations from the Healthy Campus 2010 objectives, ensures that Healthy Campus 2020 (HC 2020) will be applicable, precise, current, and pertinent as we proceed in the upcoming ten years. The realization of HC 2020 depends upon university collaborations that are both inter-university and intra-university, statewide, regional, and national; and that unite around the goals of promotion of health and healthy behavior, prevention of disease, and the improvement of academic performance. The success of these achievements depend upon leadership, creative planning and programming, and the overall determination of institutions of higher education that pave the way in building healthier campuses, in progressive ways, and campus by campus, in order to reach all college students.

FUTURE DIRECTIONS: FOCUSING ON DISEASE PREVENTION AND HEALTH PROMOTION

Healthy Campus 2010's first overarching goal of increasing quality healthy life challenges the institutions of higher education to assess and measure the complex interactions of health, disease, disability, and early death. Continued commitment to implementing effective disease prevention and health promotion interventions will facilitate progress toward this goal by the end of the decade. Healthy Campus 2010's second overarching goal of eliminating health disparities represents a further challenge. The data presented here indicate that rates are not improving for most populations. Disparities--measured in terms of relative differences from the best group rate--are generally not declining. It may be more difficult or more costly to implement effective disease prevention and health promotion programs for some populations. However, unless greater reductions occur for the populations with the highest rates, disparities will not be eliminated. Tracking progress toward the goals and objectives of Healthy Campus 2010 remains one of the most important contributions of this national initiative to improve the quality and length of life in this Nation.

REFERENCES

American College Health Association. (2002). Healthy Campus 2010: Making it Happen. Baltimore, MD: American College Health Association.

American College Health Association. (2004). National College Health Assessment: Reliability and Validity Analyses. Baltimore, MD: American College Health Association; Retrieved August 23, 2009, from http://www.acha-ncha.org/grvanalysis.html.

American College Health Association. (2005). Standards of Practice for Health Promotion in Higher Education. Baltimore, MD: American College Health Association. Retrieved August 23, 2009, from http://www. acha.org/info_resources/SPHPHE_statement.pdf.

American College Health Association. (2008a). The American College Health Association National College Health Assessment (ACHA-NCHA) Spring 2007 Reference Group Data Report (abridged). Journal of American College Health. 56, 469-479.

American College Health Association. (2008b). Hiring Guidelines for Promotion Professionals in Higher Education. Baltimore, MD: American College Health Association. Retrieved August 11, 2009, from http://www.acha.org/info_resources/ACHA_HP_HiringGuidelines_072108.pdf.

Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2006). Monitoring the Future national survey results on drug use, 1975--2005: Volume II, College students and adults ages 19-45 (NIH Publication No. 06-5884). Bethesda, MD: National Institute on Drug Abuse. Retrieved July 8, 2009, from http://monitoringthefuture.org/pubs/monographs/vol2_2005.pdf.

Park, M. J., Brindis, C. D., Chang, F., & Irwin, C. E. (2008). A Midcourse Review of the Healthy People 2010: 21 Critical Health Objectives for Adolescents and Young Adults. Journal of Adolescent Health, 42, 329-334.

US Department of Health and Human Services. (2000). Healthy People 2010. With Understanding and Improving Health and Objectivesfor Improving Health. 2nd ed. Washington, DC: US Government Printing Office. Retrieved August 11, 2009, from http://www.healthypeople.gov/Document/tableofcontents. htm#volume1.

US Department of Health and Human Services. (2001). Healthy People 2010. With Understanding and Improving Health and Objectives for Improving Health. 2nd ed. Washington, DC: US Government Printing Office; 2000. Retrieved August 11, 2009, from http://www.healthypeople.gov/Document/ tableofcontents.htm#under.

US Department of Health and Human Services. (2007). Healthy People 2010. Midcourse Review, Readers Guide. Washington, DC: US Government Printing Office. Retrieved August 11, 2009, from http:// www.healthypeople.gov/data/midcourse/html/ReadersGuide.htm.

Cynthia Burwell, EdD, CHES, F-ACHA Lori Dewald, EdD, ATC, CHES, F-AAHE Jim Grizzell, MBA, MA, CHES, ACSM-HFS, F-ACHA

Cynthia Burwell, EdD, CHES, F-ACHA, is an Assistant Professor, Director of Internship Programs, and CoChair ACHA Healthy Campus 2010/2020 Coalition, Norfolk State University, Department of Health, Physical Education and Exercise Science, 700 Park Ave., Echols Hall Rm. 165, Norfolk, VA, 23504. (757) 823-9494 (office). Email: cburwell@nsu.edu. Lori Dewald, EdD, ATC, CHES, F-AAHE, is affiliated with the Department of Health and Wellness in the College of Health Sciences, Kaplan University, 9563 Wedge Way, Delmar, MD 21875. (443) 880-0394 (office). Email: LoriDewald@yahoo.com. Jim Grizzell, MBA, MA, CHES, ACSM-HFS, F-ACHA, is an Adjunct Faculty, Department of Kinesiology and Health Promotion, California State Polytechnic University, School of Public Health and Health Services, George Washington University. 909-856-3350 (office). Email: jvgrizzell@csupomona.edu
Table 1: Percent of Target Achieved for Healthy Campus 2010
Objectivies in Focus Areas 1, 2, 5, 7, 9, 12, and 13

Focus    Objective                                     Percent
  Area                                                of Target
                                                      Achieved

1-1      Insurance                                       17
3-9a     Sunscreen Use                                   24
3-11c    Gynecological Exam                              -20
5-2      Diabetes Last Year                              -22
5-3      Diabetes Ever Diagnosed                         -7
5-4a     Diabetes Affected Academics                    -509
7-3      Received Information on All Topics              -2
9-3      Used Contraception                              20
9-5a     Emergency Contraception                         96
9-7a     Unintentional Pregnancy (Females)               113
9-7b     Unintentional Pregnancy (Males)                 103
12-12a   Blood Pressure Checked                          -31
12-15    Cholesterol Checked                             -4
13-6a1   Condom Used at Last Intercourse (Females)       31
12-6a2   Condom Used at Last Intercourse (Males)         74
13-6b1   Condom Used (Oral, Females)                      5
13-6b2   Condom Used (Oral, Males)                        6
13-6c1   Condom Used (Vaginal, Females)                  20
13-6c2   Condom Used (Vaginal, Males)                    32
13-6d1   Condom Used (Anal, Females)                     10
13-6d2   Condom Used (Anal, Males)                       12

Table 2: Percent of Target Achieved for Healthy Campus 2010
Objectives in Focus Areas 14, 15, 18, 19, and 21

Focus    Objective                             Percent
  Area                                        of Target
                                              Achieved

14-3/9   Hepatitis B and C                       31
15-19    Seatbelt Use                            33
15-21    Motorcycle Helmet Use                   97
15-23    Bicycle Helmet Use                      67
15-23a   Inline Skating Helmet Use               54
15-32    Homicides                               200
15-34    Physical Assault by Partners            -16
15-34a   Emotionally Abusive Relationship        -40
15-34b   Sexually Abusive Relationship           33
15-35a   Rape/Attempted Rape                     34
15-36    Unwanted Touching                       30
15-37    Physical Assault                        -34
15-38    Physical Fighting                       -33
18-2     Suicide Attempts                         0
18-9b    Depression and Received Treatment       12
19-1     Healthy Weight                          -54
19-2     Obesity                                 -51
19-3     Overweight/Obese                        -26
19-5/6   5+ Servings of Fruits/Vegetables        -4
21-10    Dental Care                              5

Table 3: Percent of Target Achieved for Healthy Campus 2010
Objectives in Focus Areas 22, 23, 24, 25, 26, and 27

Focus     Objective                                Percent
  Area                                            of Target
                                                  Achieved

22-2/3    Endurance Exercise                         16
22-2      Muscular Strength Exercise                  6
22-15a    Bicycling                                  -43
23-6      Population Group Objectives                100
23-7      HP2010 and HC2010 Objectives Tracked       100
24-5a     Asthmas Affected Academics                 -48
25-1a     Chlamydia (Males)                           0
25-1b     Chlamydia (Females)                        20
25-2      Gonorrhea                                  49
25-4      Genital Herpes                              0
25-5      Human Pappiloma Virus (HPV)               -122
25-6      Pelvic Inflammatory Disease (PID)          50
26-6a     Drive After Drinking                       44
26-7a     Injured Self Due to Alcohol                -20
26-7b     Fighting Due to Alcohol                    39
26-10     Illicit Drug Use (<21 years old)           21
26-10b    Marijuana                                  -12
26-10c    Illicit Drug Use                           -2
26-11b    Binge Drinking                             -4
27-1/2a   Cigarettes                                 45
27-1/2b   Spit Tobacco                                7
27-1/2c   Cigars                                      3
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