Peralta Community College District s9

Peralta Community College District Program Review

College: College of Alameda Date: April 11, 2007

TITLE OF PROGRAM: HEALTH SERVICES

Self-Study Committee Members: Patricia Dudley, Health Services Coordinator Karen Bougae, Health Services Coordinator, Merritt

Validation Committee Members: Brenda Johnson, Dean of Student Services, BCC Karen Bougae, Health Services Coordinator, Merritt Camille Hopkins, Classified Staff, COA Larry Emms, Student, COA

Additional documents submitted for this program review are:

Packet:  Position Paper of College of Alameda Health Services, 3/28/2006  Memo CCCCO, 3/17/2006  Education Code Section 76355  Education Code Sections 54702-54708  AB 982  PCCD Student Health Fee Survey

1 2 Table of Contents

BACKGROUND INFORMATION...... 5

STUDENT LEARNING OUTCOMES...... 7

PROGRAM EFFECTIVENESS...... 9

CURRENT RESOURCES AND FUTURE NEEDS...... 17

STUDENT DEMOGRAPHICS AND STUDENT PERFORMANCE...... 19

PROGRAM PERFORMANCE INDICATORS...... 21

EXTERNAL COMPARISONS...... 23

ACTION PLAN...... 25

VALIDATION TEAM REPORT...... 27

APPENDIX...... 29

Student Outcomes 2004-2005...... 31

Student Outcomes 2006-2007...... 33

Integrated Budget Planning 2005-2006...... 35

COA Needs Assessment Survey...... 47

COA Needs Assessment Survey Summary 2002-2003...... 49

Discussion of Peralta Health Fee Survey 2002...... 53

Basic Demographics Students Receiving Health Services 2004-2006...... 55

Healthy Campus 2010...... 59

PCCD Student Evaluation of College Nurse...... 61

PCCD Evaluee’s Self-Evaluation Report...... 63

3 4 Background Information

1. Description of Unit a. The college provides the services of one registered nurse to assist students in health matters. The Health Services Center is open for 30 hours a week, limited to the fall and spring semester (no summer or weekend hours). b. The Center is located in the Student Activities building and consists of a waiting room, ex- amination room, office and bathroom. Layout was planned to enable two different groups to func- tion independently in areas off the waiting room (i.e. a sexual health clinic can be held concurrent- ly with a first aid station.) c. Services that are provided include:  Health and safety education.  Assistance to clients with minor first aid problems and in emergencies.  Health evaluations for clients seeking assistance with personal health concerns.  Referrals to community agencies as appropriate.  Coordination of wellness programs with outside providers (eye care, flu shots, etc.).

2. History of Unit a. When the college opened in 1970, health services were contracted out to the Alameda County Department of Health Services. Thirty hours per week of health services were available to staff and students. In 1972, a college nurse was hired to provide those health services. In addition to the nurse, the Peralta Police were available for emergency situations. b. The current Health Services Coordinator was hired in 2002 after a period of years when College of Alameda was without Health Services. The current offices were built and occupied in the fall of 2006.

3. Current Components and Purposes a. Student health and wellness:  Educational programs comprise a major portion of health and wellness activities. The purpose of health-related activities and events is to bring a range of offerings to the college community.  Individualized health services within the scope of a registered nursing license are offered on a daily basis to students. These are specifically tailored to each student with considera- tion to type of services needed, finances, home location and personal preference. Other services are available in collaboration with community resources.  Mental health services consist of referrals for on-campus immediate intervention and community referral for crisis intervention and on-going therapy. b. Safety: The purpose of Health Services participation in campus-wide safety concerns is to be generally responsible for the health and safety of the campus and its community and to provide expert opinion in specific areas. c. Development and implementation of Health Services policies and procedures: Health Services policies and procedures are developed to ensure that district, local, state and federal regulations concerning health care policy are implemented on a consistent basis.

4. How does the unit support other administrative, student services and academic units in the college? a. Health Services contributes to the educational aims and matriculation of students by promoting their physical and emotional well being. b. Health Services supports student retention through health promotion by enabling the students to maximize his/her potential for success through healthy living.

5 c. Health Services supports instruction and other student services departments by acting as a resource and by counseling faculty/staff needing assistance with students or by accepting referrals of students from faculty/staff. d. Health Services acts a resource and provides leadership for issues of campus and environmental safety. Health Services consults with departments with particular needs (e.g. DSPS). e. Health Services refers students to other departments on campus, as needed. f. Although student services are a priority, Health Services provides limited services for faculty and staff, and will attend to faculty/staff emergencies. g. Health Services interacts with community agencies thus heightening the profile of COA.

5. Describe unique aspects of the program. 1. Health Services provides health and wellness educational programs for the campus community. 2. Health Services provides or refers for services that address the health needs (physical, emotional and/or spiritual) of our students. 3. Health Services provides an opportunity for students to utilize health resources in the community by providing them with information on sources of low cost or free services. 4. Health Services provides case management and advocacy services for students. 5. Health Services provides expertise in areas of health and safety matters for various campus and district groups.

6 Student Learning Outcomes

1. What should your student know and/or be able to do as a consequence of the service provided by your unit?

After obtaining health services, students will be able to understand and participate in healthy behaviors.

2. Describe the activities that have been implemented to achieve the SLO.

Since health education is one of the primary goals of Health Services, new activities were not needed to achieve student learning. Evaluation of learning was accomplished by administering pre- and post- tests to assess the pre-contact level of awareness and to evaluate the extent of post-contact change.

7 8 Program Effectiveness

1. What is the program goal? a. The mission of Health Services at College of Alameda is to further the equality of educational opportunity and success by providing health education and access to health services.  Health Services is an integral part of the college, supports its objectives, and receives support from the college in performing its responsibilities.  Health Services believes that good health is essential to student success. Health Services actively promotes self-care and wellness.  Health Services is committed to providing health education, health and prevention programs, and early illness prevention to better enable students to fulfill their personal and educational goals.  Our programs are designed around a concept of wellness that integrates all the elements of a student’s life: physical, emotional, social, spiritual, intellectual and occupational.  It is hoped that students will be empowered to make positive choices which contribute to academic success, academic retention and future contributions to the community. b. Health education and access to services for students can be focused in the following areas as described in Healthy Campus 2010 by the American College Health Association1:  Physical activity  Overweight and obesity  Tobacco use  Substance abuse  Responsible sexual behavior  Mental health  Injury and violence  Environmental quality  Immunization  Access to health care

2. What needs does the program address? a. The program addresses the need for health education. As not all areas of health education can be addressed within the scope of this program, educational needs must be prioritized. b. The program addresses the need for health services and/or referral to community health services. Limited direct services, within the licensure of a registered nurse, are provided. Refer- rals are made with sensitivity to financial circumstances and cultural and language needs for health services outside this scope of practice. c. The program addresses the need for a safe and healthy education environment. Health Services is an active participant in college and district committees addressing these concerns.

3. How do you know that the program is meeting its goal?

a. It is difficult to determine what impact Health Services has on the broad student population. Although statistics are provided later in the self study on the cohort that was seen for health evaluation, no statistics are available that refer to the many students who are exposed to health education broadly offered on campus and non-active (via handouts or brochures available in the Health Services office) referral. b. There is no data that provide information on students’ contributions to the community. c. There is some data in the area of health education concerning tuberculosis (communica- ble disease) and vision health, demonstrating that learning in these areas has occurred. Limited pre- and post-testing of defined student learning outcomes have been in use since 2004-2005. A pre- and post-education survey regarding drug and alcohol attitudes and use will be implemented.

1 American College Health Associations, Healthy Campus 2010, , Appendix p. 59. 9 Although not tested for pre- and post change, multiple health education events and activities are carried out daily. d. Access to health services: Daily health care and referrals are provided, but no data is available concerning the impact these services have on improving individual academic success, student retention and contributions to the community. The cohort seen in Health Services does show higher rates of success, retention and persistence, but it is difficult to determine if more successful students self-selected to come to Health Services or if these students are more successful because they came to Health Services.

4. How do you know that the program goals are aligned with student needs? The following two surveys attest to the need for education and services. Safety was not addressed. a. A needs assessment survey was conducted at College of Alameda in Spring 20032. Topics are listed with corresponding percentage of students who expressed interest in topic:

1) Top ranking items for “Information Wanted:” a) Exercise and Diet 45% b) Stress Reduction 45% c) Sexually Transmitted Disease 39% d) AIDS 38% e) Healthy Lifestyles 36% f) Anger Management 34% 2) Top ranking items for “Services:” a) Testing for STDs 64% b) Testing for HIV 54% c) Testing for Pregnancy 54% d) TB Testing 49% 3) Top ranking items for “Semester Length Class:” a) Sexual Behavior, etc 47% b) Weight Management, etc 46% c) Alternative Medicine, etc. 40% d) Anger Management, etc. 38% e) Drugs and Alcohol 37% f) Politics of Health, etc. 35% 4) Top ranking items for “One Day Programs:” a) Eye Exams 54% b) Stress Reduction 51% c) Dental Clinic 48% d) Blood Drive 46% e) AIDS Awareness 45%

It is felt that this Needs Assessment Survey was well intentioned but was selective in its question- ing. A better survey, with tested questions and a broader range of questions should be investigated and used. An example of a more holistic tool would be the National College Health As- sessment.

b. A district wide survey was administered in 2002. The Survey Highlights of the Student Health Fee Survey 20023 follow:

2 COA Needs Assessment Survey, Appendix page 47. 3 See Additional Documents. Chan, Chuen-Rong and Portero, Connie. Student Health Fee Survey. Oc- tober 2004. 10  82% of the students surveyed indicate that they want health services to be provided at their college.  Twenty-eight percent of respondents said that health problems or stress had caused them to fall behind in their studies.  When asked if they would be willing to pay for health services, 56% said yes. Of those who said yes, 51% were willing to pay $5 per semester, 21% would pay $7 and 26% would pay $12 per semester for health services.  When asked what type of health insurance they had, 17% said Medi-Cal, 46% said other, and 28% said they had no health insurance.  Twenty-eight percent of respondents receive financial aid.

Conclusion of the Peralta Health Fee Survey

“The results of this Health Services survey indicate that students have health concerns that affect their performance in their classes. A significant majority of surveyed students want health services provided to them on campus. Survey results also indicate that there are specific types of health services that are important to our students. “

Discussion of Survey (See Appendix, page 54)

5. Explain the process that was used by your program to meet those needs.

Advertising the availability of Health Services was begun and maintained. Referrals were determined and handouts collated. Printed material was provided. Collaborative relationships with student organizations and campus services were established and utilized. Office hours were adjusted to accommodate student need. Presentations were offered. An annual Health Fair was institutionalized. A website was established. Collaborative relationships with community organizations were established.

a. Physical activity: Addressed through availability of printed material and one-on-one counseling and/or referral with students. Gymnasiums and other facilities attend the annual Health Fair. Demonstrations of types of physical activity were presented at the annual Health Fair. b. Overweight and obesity: Addressed through availability of printed material and one-on-one counseling and/or referral with students. Overeaters Anonymous and Weight Watch- ers attend the annual Health Fair. c. Tobacco use: Addressed through availability of printed material and one-on-one counseling and/or referral with students. Smoking Cessation agency invited to the annual Health Fair (was a no-show). Active in the development of current limited smoking on campus policy. Movies, workshops and speakers are planned for Spring 2007, including information regarding the politics behind the Big 8 Tobacco companies and the addictive properties of tobacco. A short term course for smoking cessation is being investigated. Attended a smoking cessation train-the trainer in 2002-2003. d. Substance abuse: Addressed through availability of printed material and one-on- one counseling and/or referral with students. Participate in workgroup to enforce the guidelines in the Drug-Free Schools and Campuses Act of 1989. Includes planning for administration to assess current level of alcohol use and abuse amongst students. Investigation regarding evi- dence-based methods of changing attitudes and behaviors is under way. Referrals posted on website. e. Responsible sexual behavior: Addressed through availability of printed material and one-on-one counseling and/or referral with students. Planned Parenthood clinic available on campus since Spring 2005, providing contraceptive information and testing of sexually transmitted infections. HIV/AIDS presenters on campus at each annual Health Fair. The Alameda County 11 Prevention and Education Project mobile testing and counseling van for HIV infections has peri- odically been on campus from 2003-present. In conjunction with Cal WORKS, there have been several presentations regarding HIV/AIDS (some by the Magic Johnson Clinic). Referrals for outside STI and HIV testing are available daily. Referrals are also posted on the Health Services website. Pregnancy testing is consistently available. Condoms are consistently available in the Health Services Center. University of California at Berkeley peer sexuality educators have been on campus either at the Health Fair or in other events since 2003. Men may attend the Planned Parenthood clinics. f. Mental health: Addressed through availability of printed material and one-on-one counseling and/or referral with students. Crisis Team meets monthly to discuss and evaluate group and individual concerns. Each semester a workshop is conducted for faculty and staff to support their efforts to deal with students in crisis, and to help them be aware of sources for referral. Referral for limited counseling can be made to campus counselors. Referrals posted on website. Information related specifically to stress reduction for students is available both in print and on the website. Stress reduction programs have been offered by Cal WORKS. Counseling for mental health problems was available on campus for several years. The counselor was paid for by Cal WORKS and was available one day a week. Due to lack of funding, this program was discontinued. Crisis counseling is available via the Crisis Team. Additionally, the Berkeley Depression and Anxiety Clinic is available for Peralta students with anxiety and depression, and is moderately priced at $10 per visit. g. Injury and violence: Addressed through availability of printed material and one-on- one counseling and/or referral with students. Referrals posted on website. Some issues addressed via Crisis Team. In conjunction with Cal WORKS, there have been several presentations regarding domestic violence and anger management. Printed material is available thought the Health Services Center. Consultation with Sheriff over specific issues. Information related specifically to anger management is available. h. Environmental quality: Acted as consultant with on-campus emergency. Link with Sustainable Peralta on website. i. Immunization: Addressed through availability of printed material and referral. Co- ordinator attended recent seminar to maintain currency. This service is not available on campus as it was determined that a potentially life-threatening (although rare) side effect made it ill-ad- vised to conduct immunizations on campus without direct physician oversight. j. Access to health care : Addressed through availability of printed material and referral with students. Posted on website. Insurance counseling provided. Limited services provided on-campus. Development of relationships with community providers. Planned Parenthood provides services. University of Pacific has provided on-campus dental services. The dental clinics were held for several years on an annual basis. They are presently suspended as the Dental As- sisting program moves into a new facility. There is an optometrist on campus once a semester for vision testing and the dispensing of glasses. Students can be referred at any time to UCB Op- tometry School for low cost exams and glasses. Flu shots yearly on campus. Testing for tuberculosis is offered consistently. Services of a registered nurse are provided at COA. No direct physician medical services are provided, although students can be referred to community providers. Planned Parenthood services are provided by a nurse practitioner, under the direction of a physician. Student without health insurance are appropriately referred. There are low/no income community clinics. Student health insurance is available for those with some income. k. Other: Alternative Medicine resources are listed in printed material in the Health Services Center. Blood drives were held for several years, but were discontinued due to the low number of eligible participants (because of international travel, many students were disqualified). Present arrangements with the American Red Cross for blood donations include their participation in the annual Health Fair and the posting of information regarding outside blood donation events.

6. Please indicate how staffing hours are planned to meet student needs. 12 During the 2003-2004 year, hours were altered to accommodate evening students. One day a week hours were extended until 1900. Because only one student was seen during those evening hours, they were discontinued.

7. Do you provide an opportunity for student feedback?

The “COA Satisfaction Survey” has been consistently available in the waiting area of the Health Services Center since approximately 2003. The Health Services Coordinator has frequent contact with ASCOA and Student Activities to obtain feedback.

8. How do you know that students are satisfied with your program?

A tenured faculty evaluation was done during Fall 20024. Student feedback was provided during this process. The Health Service Coordinator did not see these results and they are currently unavailable in the District Office. No indication was made by administration that students were dissatisfied.

Results from another satisfaction survey were returned to Health Services. The result contained a variety of student complaints. It was difficult to assess from this survey whether students were complaining about current services or lack of services. This survey is also not available.

On a one-to-one basis, students express satisfaction with the services offered, with the exception of the comment made “you were not here….”, meaning that the Health Services Coordinator was not in the office. Health Services is not open 24/7, and the coordinator may not be continually in the office. The Coordinator is absent for mealtimes, meetings and other campus activities. Please see Action Plan in this document for a possible solution.

9. How does your program contribute to Student Learning Outcomes? a. Health Services was one of the first departments on campus to institute Student Learning Outcomes. b. Health Services met with several campus departments and/or department coordinators to consult with them regarding the creation of Student Learning Outcomes for their areas. c. Health Services shared COA Student Learning Outcomes with the Health Services Coordinators at Laney and Merritt.

10. Please list all the activities in which faculty members participate regularly. a. Health Services Events and Activities: Daily activities of Health Services are: student education, first aid, assessment, referral, planning campus programs and events, crisis services, development of programs of interest, needs assessment, research and recommendations for student insurance plans, establishment of preventive programs, and coordination with community programs. Regularly scheduled events are: Annual Health Fair, HIV Test- ing, Eye Exam Programs, Flu Shot Clinics, Safe Sex Events, Great American Smoke Out, Bone Marrow Drives, Planned Parenthood Clinics, and Crisis Team Workshops. b. Administrative Activities: Policies and procedures reflecting district, local, state and federal regulations are written and implemented. Activity is on-going with the following:  Campus smoking regulations  PCCD sexual assault policy  Drug and Alcohol Free Campus regulations  Pandemic Emergencies  Disabled Student Evacuation policy

4PCCD Student Evaluation and Self-Evaluation Report in Appendix pages 61-64. 13 c. Other faculty activities:  Health Services website  Staff Development website  Crisis Team website  Investigation and follow-through with campus environmental safety issues.  Hazardous condition reports  Accident reports  Participation in campus disaster programs  Participate in campus safety programs  Trainer and liaison with faculty and staff with students in crisis  Develops and maintains a system of statistics and confidential student records  Works with college community to develop a comprehensive health program  Budget development and implementation  Maintaining currency in the profession d. Committees: COA Safety Committee and subcommittee on Pan- demic Planning, District Safety Committee, COA Crisis Team, Student Services Council, Staff Development Committee, College Council, tenure committee (Math), DSPS Advisory Committee, Dental Assisting Advisory Committee, meetings with district Health Services Coordinators and the Risk Manager.

11. What impact does the program have on other programs/departments/services at the college? a. Campus-wide:  Health Services contributed to the campus-wide change in smoking policy, once in 2004 and again in 2006.  Health Services contributed to motivating the district office to mark and repair the uneven pavement on campus. Health Services contributed to raising this as a safety issue, thus leading to prioritizing the replacement of the walks.  Health Services led the way with COA’s website by construction and design of a holistic Heath Services site, and by providing instruction and support of other departments in the construction of their sites.  Health Service’s student learning outcomes were used as a model for others at COA and in the district.  Health Service’s integrated budget planning was used as a demonstration model and shared with others at COA.  Health Services arranged for training of selected campus staff and faculty in CPR and the use of the automatic external defibrillator.  Health Services arranged for the Alameda Fire Department to survey the campus’s disability evacuation capabilities. It was determined that the campus was constructed so that, in the event of an emergency, evacuation for disabled student was sufficient.  Health Services has provided guidance for the Children’s Center in complying with state law regarding the automatic external defibrillator housed in their facility.  Health Services determined the need for a specialized policy regarding the treatment of minors on campus and worked collaboratively with ASTI to write and implement the policy.  Health Services participated in the development of guidelines and provides counseling and training on the management of disruptive students in the classroom. b. Peralta Community College District:  Health Services researched and wrote a policy concerning automatic external defibrillators for the COA Safety Committee. This policy is providing a basis for a district-wide policy.  Health Services served as chair of a COA Safety committee sub-

14 committee that researched and wrote the college policy and provided a basis for a district policy on pandemic planning.  Health Services at COA pursued the change of title of College Nurse to Health Services Coordinator. This change was approved by the District Academic Senate and is pending approval by the district.  Health Services, in collaboration with DSPS and disabled students, is pursing a district-wide policy for emergency evacuation of disabled students.

12. How do other programs impact your program? a. Cal WORKS and Student Activities provide financing for events, inspiration and resources for workshops and other health-related activities. b. ASCOA: Health Services has presented programs per the request of students. c. DSPS consults with Health Services, acts as a consultant for Health Services, participates in Crisis Team and provides counseling for student in crisis d. The Children’s Center consults with Health Services and acts as a consultant for Health Services. e. EOPS is a source for referrals for student needing counseling. EOPS has made their email list serve available for the upcoming alcohol and drug survey of students. f. Financial Aid has made their email list serve available for the upcoming alcohol and drug survey of students. They have made students workers available for Health Services. g. By sharing experiences and problems about students in crisis, all areas of the college community have participated in improving services.

13. If your program does have an impact on other programs, please describe the nature of the relationship with the program and the effectiveness of the relationship. a. Instruction: Helping students to solve their health-related problems may contribute to each student’s ability to persevere in their academic pursuits. b. Cal WORKS: Health Services acts a consultant, provides advertising expertise, attends to some details of event preparation, and provides resources. This is a very effective working relationship with multiple collaborations. c. Student Activities: Health Services acts a consultant, provides advertising expertise, attends to some details of event preparation, and provides resources. Very effective working relationship with multiple collaborations. d. DSPS: Health Services acts a consultant in some areas. Effective working relationship with some collaboration. e. Children’s Center: Health Services acts a consultant in some areas. Effective working relationship. f. ASTI: Health Services acts a consultant in some areas. Effective working relationship. g. EOPS: Refers student to EOPS counselors for assistance. Effective working relationship, although used infrequently. h. COA Safety Committee: Health Services acts as a representative for various college groups (student, faculty, classified) by brining safety issues forward. Health Services also acts a consultant for problem solving. Health Services promotes the writing of safety policies and procedures. i. General college community: Health Services provides education, consultation and referral for all aspects of the community. As utilized, the relationships appear to be effective.

14. Does your program/department/service collaborate, communicate or exchange information on best practices with other campuses? a. Yes: Merritt College, Laney College, Berkeley City College, Diablo Valley College, 15 Santa Rosa College, West Valley Community College. b. The Health Services Coordinator is also a member of the Health Services Association of California Community Colleges.

15. Do you participate in any governance groups? Yes: College Council, Staff Development (chair), PFT representative.

16. Quantity of service delivered (student utilization of services and student engagement) a. How many students do you serve (unduplicated)? 552 new clients requiring health evaluation presented in the Health Services Center from Fall 2002 – Spring 2006. This number includes clients who presented for health evaluation with visits requiring more than minimal contact and does not include contacts not requiring a medical history (condom requests, student health insurance assistance, referrals, etc). b. How many appointments do you have on any given day? From Fall 2002 – Spring 2006, there were 1479 client visits. Based on an academic year of 175 days, there were approximately 2.1 visits per day. This group represents the same as above, and does not reflect minimal contact visits. c. How many contacts do you make with students? The average is 2.6 contacts per student, not including minimal contact visits.

16 Current Resources and Future Needs

1. Describe your current resources. a. Financial resources: Health Services received a budget of approximately $6000 in the 2006-2007 year. This funding was sufficient for health education and health services as described above. A request for the same amount was made for fiscal year 2007-2008. b. Facilities: A new facility was completed in October 2006. This facility was designed to accommodate multiple concurrent client visits and specialized programs. An area for a clerical worker was designed into the facility plan, but until computer and telephone resources are adequate, it is not possible to have a second person working in the area. The facility is small but sufficient for current needs. c. Personnel: A registered nurse is employed for 175 days per year, 30 hours per week. A student worker was briefly utilized but not renewed due to difficulties with facilities. d. Equipment and supplies: Sufficient equipment and supplies are provided or otherwise available with current budget. Health Services is in the process of obtaining equipment to meet the needs of physically larger students. 2. Describe the future needs of the program. a. Financial resources: As funding is presently adequate, a continuation of this funding with appropriate cost-of-living increases is sufficient for this level of service for the current number of students. b. Facilities: Facilities are adequate for present services. c. Personnel: It would be preferable for Health services to ally with Student Activities to share a classified assistant for purchasing, telephone activities, and other assignments. Most importantly, in the absence of the Health Services Coordinator (for meetings, emergencies, illness, confer- ences), it is a quality issue to have clerical support to answer the phone, greet drop-in students and make clients aware of when the coordinator would return. It is not possible to have clerical or student assistance in the area without the resources described in 1b (above). d. Equipment and supplies: These are adequate with funding as described in 2a (above) to meet future needs.

17 18 Student Demographics and Student Performance

1. Who uses your services, programs, and facilities? Who does not utilize your services, programs, and facilities?

The analysis of Health Services data was performed by Bruce Hawkins in the district office5.  176 social security numbers of new clients seen from Fall 2004 to Spring 2006 were available for analysis; other new clients did not provide numbers. The new clients were composed of individuals who completed intake forms for health evaluations, not clients who used Health Services for brief visits (i.e. condoms, referrals, insurance information, etc.). Of the 176 numbers submitted, 21 were faculty/staff. The enrollment status of 18 of the sample was unknown.  Health Services data was compared to COA data for Fall 2004 and Spring 2005, and Fall 2005 and Spring 2006. Summer enrollment was not compared in the summary and comparison statements below.  Summary: The statistics for students seen in Health Services show that they were generally female, Asian or African American, 19-24 years old with a disability. They were generally continuing students receiving financial aid who were not on probation, with higher than average success, retention and persistence rates. The average GPA was 3.03. Although the cohort seen in Health Services does show higher rates of success, retention and persistence, but it is difficult to determine if more successful students self-selected to come to Health Services or if these students were more successful after or because they came to Health Services.

In comparison with the general population of students at College of Alameda, the study group using Health Services for a health evaluation were:  Gender: Females seen in Health Services accounted for a greater percentage than the general COA student population.  Race/Ethnicity: A smaller percentage of Asian, Filipino and white, non-Hispanic/Latino students, but a greater percentage of African American and Hispanic/Latino students than the COA general population were seen in Health Services.  Age: A smaller percentage of 16-18 years olds, 19-24 year olds and 30-34 year olds were seen in Health Services, and a greater percentage of 35-54 year olds. An equivalent number of 25-29 and 55-64 year olds were seen.  Student with disabilities: A greater percentage of students with disabilities were seen in Health Services.  Financial Aid Status: A much greater number of students receiving financial aid were seen in Health Services (COA general population student receiving financial aid 40-43%; seen in HS 73- 78%).  Enrollment Status: Most students seen in Health Services were continuing/returning students. They accounted for 64-89%. In the COA general populations, 58-70% of the students are continuing students.

2. How do students who receive services perform? How do their counterparts who do not receive services perform?

In comparison with the general population of students at College of Alameda:  Retention: Average student retention over the time period studied was 69.6 – 73.7% but the group seen in Health Services was retained at rates 92.1 – 95.1%.  Persistence: Persistence in the general population was 29.9 – 52.2% and in the Health Services group was 53.7 – 81.4%.

5 Please see Health Services data in Appendix, pages 55-58.

19  Successful course completion: Success in the COA student population was 64.6 – 66.9%. The group seen in Health Services showed success at 74.3 – 79.7%.  GPA: GPA for the general population ranged from 2.8 – 2.92, and in the HS group was 2.94 – 3.09.  Probationary Status: When students who were dismissed were eliminated from the statistics, Health Services saw students whose status was equivalent to the general population.

20 Program Performance Indicators

What are the indicators of improved performance of your program or unit?

1. Student Learning Outcomes: Student Learning Outcomes are administered yearly and progress reports made at the end of each academic year. During the last two years, there has been a substantial increase in learning as evidenced by these indicators. 2. Drug and Alcohol Use Survey: As a beginning effort, it is planned that in either Spring 2007 or in Fall 2008, a survey will be conducted to determine attitudes toward and use of illegal drugs and alcohol among students (CORE Survey6). Education regarding these topics will then be conducted. The students will then be resurveyed. The content and quality of the drug and alcohol education program will subsequently be based on the findings of this survey. 3. Future Options: It is hoped that College Health 2010 can be used a framework to guide and clarify both education and services. To evaluate goals established within this framework the National College Health Assessment7 can be administered, and findings evaluated. In order to use adequate performance indicators such as those mentioned above (#2 and 3), an appropriate commitment from administration in terms of funds (survey costs) and personnel (professional research guidance and assistance) must be made.

6 Southwestern Illinois University Carbondale. CORE Survey, Short Form. Developed in 1989. < http://www.siuc.edu/~coreinst/ > 7 American College Health Association. National College Health Assessment. Developed in 1998, pilot tested 1998-1999. < http://www.acha-ncha.org/overview.html > 21

22 External Comparisons

Have you used national assessment instruments to assess your program?

Please refer to Program Performance Indicators #2 and #3 above. The National College Health Assessment is not widely used among California community colleges, but is used at Santa Rosa Junior College and Foothill College. My emails to both colleges regarding the survey have gone unanswered to date.

Action Plan

Using the results of the data collected and discussed in the self-study, identify:

1. The strategies and actions to be taken by the unit over the next six years to strengthen the program and meet the strategic goals of the college. a. Institutional Goal/Strategy: Provide exemplary teaching and learning environments and experiences to meet student needs through relevant curricula, innovation, partnerships, technology, research and evaluation. Create policies and procedures that ensure Health Services is operating within state and federal guidelines and that registered nurses are acting within their licensure. Ensure that college and district policies provide a safe, healthy environment for students. b. Institutional Goal/Strategy: Facilitate student learning and goal attainment by providing comprehensive educational programs and services in diverse, accessible formats and locations. Offer mental health and counseling services on campus in a consistent manner. c. Institutional Goal/Strategy: Utilize existing human, physical, technological, and fiscal resources efficiently and effectively and increase external funding. Evaluate the impact of a health fee at other community colleges. Include the impact of health services on academic success and student retention. Make a final determination of the direction of Health Services and whether or not the institution of a health fee will be pursued.  Consider various situational scenarios of spending the health fee before determining its value.  It is not necessary to conduct another survey at Peralta to determine whether or not students want health services on their campuses (they do) and how much they would like to pay (very little).  It is necessary to determine that the health fee will substantially provide a benefit for students by providing a broader and more sufficient range of education and services.  Understand the present health care climate, limited resources, and the costs of goods and services before making a determination. d. Institutional Goal/Strategy: Provide exemplary teaching and learning environments and experiences to meet student needs through relevant curricula, innovation, partnerships, technology, research and evaluation. Use generally accepted guidelines, such as Healthy Colleges 2010, and conform Health Services practice to those standards. Unlimited services cannot be provided by one practitioner, so it is necessary to prioritize to achieve the maximum impact for the student body. e. Institutional Goal/Strategy: Provide exemplary teaching and learning environments and experiences to meet student needs through relevant curricula, innovation, partnerships, technology, research and evaluation. Use standardized tools, such as the National College Health Assessment, to assess practices.

2. The support needed by the unit in order to address issues resulting from the self-study. a. Effective policies and procedures must be approved by a consulting board, such as an Advisory Committee. Provide nurse with adequate time and resources to write policies. Provide remuneration to physicians to approve policies before submittal to an Advisory board. b. Investigate various scenarios to provide for permanent funding for an on-campus counselor or therapist. c. Direct college researcher to investigate issues surrounding the effectiveness of a health fee and subsequent change in education and services. Institute an investigative committee, providing time and resources, to make a final determination for recommendation to the board of the Peralta Community College District. d. Support actions and practice of Health Services Coordinator for use of the guidelines of Healthy Colleges 2010. e. Provide resources (funds and personnel) for use of an assessment tool like National College Health Assessment. Consider sabbatical leave for the Health Services Coordinator to pursue education in changing attitudes of large populations with regard to health issues, and measurements of those changes.

25 26 Validation Team Report

Unit reviewed: COA Health Services Date:

Self-Study Team

Karen Bougae, RN, Health Services Coordinator, Merritt College Patricia Dudley, RN, Health Services Coordinator, College of Alameda

Validation Team

Brenda Johnson, Dean, Student Services, Berkeley community College Camille Hopkins, Student Activities Coordinator, College of Alameda Karen Bougae, RN, Health Services Coordinator, Merritt College Larry Emms, Student, College of Alameda Patricia Dudley, RN, Health Services Coordinator, College of Alameda

Summary of Findings

Part A. Accuracy of Self-Study/Action Plan (program strengths, areas for improvement, data collection, projection of future trends/support).

Part B. Validation Team Recommendations

27 28 Appendix

29 30 Student Outcomes 2004-2005 Mission: The Health Services Center contributes to the educational aims and matriculation of students by promoting his/her physical and emotional well-being.

Goal: To evaluate the extent of student learning during health-related activities sponsored by the Health Services Center. Recipients of Services: Recipients of Health Services include all students (day and evening), staff, and faculty. For the purposes of this document, this population group will be known as “clients.”

Intended Client Learning Outcomes Measures Of Assessment Assessment Results Use Of Results And Criteria For Success 1. After participation in the Eye Care Pre and post testing. Success Fall: Continue with educational ac- Clinic, clients will demonstrate in- = a significant improvement in Pretest Average Score = tivity. creased understanding of selected scores between the pre-test 48.75% (n=20) eye diseases, and measures to take and post-test. Posttest Average Score = that foster wellness. 80.75% (n=13) 32% improvement

Spring: Pretest Average Score = 30.56% (n=27) Posttest Average Score = 73.20% (n=14) 42.6% improvement

Intended Client Learning Outcomes Measures Of Assessment Assessment Results Use Of Results And Criteria For Success

31 2. After receiving a Tuberculosis Pre and post testing. Success Pretest (n=41) average Continue with educational ac- Screening Test, clients will demon- = a significant improvement in score = 39% tivity. strate an increased understanding of scores between the pre-test Posttest (n=37) average the meaning of the skin test, TB dis- and post-test. score = 68.75%. ease transmission and the difference 29.75% improvement. between TB disease and TB infection. 3. After discussion of various Student Pre and post testing. Success Not done. Goal was Health Insurance options, clients will = a significant improvement in added later in the semes- demonstrate increased understanding scores between the pre-test ter and I forgot about it. of terms related to insurance, and be and post-test. able to differentiate between the various available policies. 4. After receiving Blood Pressure Pre and post testing. Success Not done. Goal was Screening, clients will be able to state = a significant improvement in added later in the semes- normal values of blood pressure and scores between the pre-test ter and I forgot about it. the implications of elevated blood and post-test. pressure.

32 Student Outcomes 2006-2007 Mission: The Health Services Center contributes to the educational aims and matriculation of students by promoting his/her physical and emotional well-being.

Goal: To evaluate the extent of student learning during health-related activities sponsored by the Health Services Center. Recipients of Services: Recipients of Health Services include all students (day and evening), staff, and faculty. For the purposes of this document, this population group will be known as “clients.”

Intended Client Learning Outcomes Measures Of Assessment Assessment Results Use Of Results And Criteria For Success 1. After participation in the Eye Care Clinic, Pre and post testing. Suc- Pretest (n=17) average Continue with educational ac- clients will demonstrate increased under- cess = a significant im- score = 28% tivity. standing of selected eye diseases, and provement in scores be- Posttest (n=10) average measures to take that foster wellness. tween the pre-test and post- score = 65%. test. 37% improvement. 2. After receiving a Tuberculosis Screening Pre and post testing. Suc- Pretest (n=31) average Continue with educational ac- Test, clients will demonstrate an increased cess = a significant im- score = 42% tivity. understanding of the meaning of the skin provement in scores be- Posttest (n=22) average test, TB disease transmission and the dif- tween the pre-test and post- score = 75%. ference between TB disease and TB infec- test. 33% improvement. tion. 3. After participation in the Crisis Team Pre and post testing. Suc- Pretest (n=2) average Continue with educational ac- Workshop, participants will demonstrate an cess = a significant im- score = 50% tivity. increased understanding of actions to take provement in scores be- Posttest (n=10) average Consider improving test ques- for a student in crisis. tween the pre-test and post- score = 53%. tions. test. No significant improve- Testing not done during spring ment. semester.

33 34 Integrated Budget Planning 2005-2006 Planning Unit’s Goals, Objectives and Activities: 2005-2006

Division: Student Services Planning Unit: Health Services

College of Alameda Strategic Direction: Increase Enrollment Increase Student Success Curriculum development (circle all that apply)

College of Alameda Goal: College of Alameda will improve administrative services in support of institutional effectiveness.

Planning Unit’s goals and objectives in support of the institutional goal above Goal: Promote and provide superior customer service among all college constituencies. Success is obtained when students and employees are functioning in a healthy manner: when they are attending classes, op- timizing performances, meeting goals, and being active members of their communities. Education regarding such health – Objective: related issues as drug/ alcohol use, smoking, unwanted pregnancy, anger management, domestic abuse and others, support the college community by maximizing performances. Activities/Tasks Outcomes/Assessment Responsibility Cost Timeframe 1. After receiving a Tuberculosis Screening Test, Pre and post testing. Success = a clients will demonstrate an increased understanding significant improvement in scores Health Services Coordi- of the meaning of the skin test, TB disease transmis- between the pre-test and post-test. $150 Ongoing 2005-2006 sion and the difference between TB disease and TB nator infection. 2. Number of students seen in Health Services Increasing utilization of Health Health Services Coordi- Center is increased. Number of student partici- Services promotes students well- $900 Ongoing 2005-2006 nator pants in Health Services Programs is increased. ness 3. Student Equity Plan 1.1.7 Augment seminars in the Student Lounge with speakers and video- Presentation by Planned Parenthood tape presentation from county and federal and/or similar agency concerning Fall 2005 and/or Spring Health Services Coordinator $200 agencies in the areas of family counseling family planning, parenting, sexually 2006 ...parenting …. transmitted disease and sexual health.

4. Student Equity Plan 1.1.9 Increase the cur- Agencies at annual Health Fair repre- Health Services Coordinator $500 Fall 2005 rent cultural actives to promote college pro- sent a diversity of interests.

35 grams in support of diverse student populations, including motivational speakers from the GLBT community. 5. New Health Services facilities is opened and Due to the remodel of the A- Health Services Coordinator $500 January 2006 operating in the F-Building. Expenses such as building, health Services has been telephones and signage will arise. An opening relocated. Opening is expected in celebration is planned. 2005-2006.

Reference: Accreditation Self-study, Spring 2003, page Education Plan, 2004-2019, page Attached. Student Equity Plan, April 2005, page Student Learning Outcomes Attached.

Other (such as Matriculation Plan, Enrollment Management Plan, Program Reviews)

36 Integrated Budget Planning 2006-2007

Division: Student Services Planning Unit: Health Services

College of Alameda Strategic Direction: Increase Enrollment Increase Student Success (circle all that apply)

College Of Alameda Institutional Learning Outcomes: Apply abstract concepts to real world situations, demonstrating problem-solving, decision-making, and critical thinking.

Planning Unit’s goals and objectives in support of the institutional goal above

Goal: Students apply knowledge gained during health services events to activities of daily life.

Objective: Below activities/tasks are assessed; services are improved.

Activities/Tasks Outcomes/Assessment Responsibility Cost Timeframe After receiving education on Sexual Assault via a workshop Pre and post testing. Success = a signifi- and/or student ambassador presentations in classes, cant improvement in scores between the Health Services Coordinator, clients will demonstrate an increased understanding of the pre-test and post-test. Crisis Team, Student Activities $350 Fall 2006 laws concerning sexual assault, its prevention and the re- and student ambassadors porting procedures for COA. Domestic Violence surveys are posted in bath- Success = the number of students Health Services Coordinator rooms to heighten awareness and to encourage who are referred to Health Services in conjunction with referral $500 Fall 2006 seeking assistance. are increased over previous year. agencies. Continuance of monthly Family Planning/STD clin- Success = the number of students ics. who are referred for Planned Parent- Health Services Coordinator $300 Fall 2006 hood services are increased over previous year.

Reference: 1.1.7 Augment seminars in the Student Lounge with speakers and videotape presentation from County and federal Student Equity Plan, April 2005 agencies in the area of family counseling, general assistance, parenting, childcare, financial planning. Student Learning Outcomes See above

Other (such as Matriculation Plan, Enrollment Man- AB 1088 agement Plan, Program Reviews)

37 Division: Student Services Planning Unit: Health Services

College Of Alameda Institutional Learning Promote and maintain physical fitness and healthy well-being in order to succeed in a career or contin- Outcomes: uing education.

Planning Unit’s goals and objectives in support of the institutional goal above Goal: Health Services provides opportunities for learning about physical fitness and well-being.

Objective: Below activities/tasks are assessed; services are improved. Activities/Tasks Outcomes/Assessment Responsibility Cost Timeframe After participation in the Eye Care Clinic, Pre and post testing. Success = clients will demonstrate increased understand- a significant improvement in Health Services Coordi- $100 Ongoing 2006-2007 ing of selected eye diseases, and measures to scores between the pre-test and nator take that foster wellness. post-test. Information is presented (monthly basis) con- Health Services Coordi- cerning various Wellness Issues, such as ex- Presentations are completed. $500 Ongoing 2006-2007 nator ercise, mental wellness and nutrition. Health Fair Committee, Health And Fitness Agencies are present at A variety of agencies are repre- with Health Services Co- $750 Fall 2006 the annual Health Fair. sented. ordinator After receiving a Tuberculosis Screening Test, Pre and post testing. Success = clients will demonstrate an increased under- a significant improvement in Health Services Coordi- standing of the meaning of the skin test, TB scores between the pre-test and $350 Ongoing 2006-2007 nator disease transmission and the difference be- post-test. tween TB disease and TB infection. Reference: One of the secondary effects of the (remodel of the A-building) is that the office and treatment room for health Services must be relocated from Building A to the Student Center, Building F. New Health Ser- Accreditation Self-study, Spring 2003 vices facilities are opened and operating in the F-Building. Expenses such as telephones and signage will arise. An opening celebration is planned. Student Learning Outcomes See above.

College Of Alameda Institutional Learning Demonstrate the application of scientific principles to everyday phenomena. Outcomes:

Planning Unit’s goals and objectives in support of the institutional goal above Goal: Students incorporate disease prevention techniques into daily life.

Objective: Below activities/tasks are assessed; services are improved. Activities/Tasks Outcomes/Assessment Responsibility Cost Timeframe Pre and post testing. Success = After receiving influenza vaccine, students will a significant improvement in Health Services Coordi- understand about the communicability and pre- $200 Fall 2006 scores between the pre-test and nator vention of influenza disease. post-test. Reference: Student Learning Outcomes See above.

College Of Alameda Institutional Learning Understand diversity and apply it in relationships and interactions with others. Outcomes:

Planning Unit’s goals and objectives in support of the institutional goal above Goal: Students appreciate diversity especially with concern to health issues.

Objective: Below activities/tasks are assessed; services are improved. Activities/Tasks Outcomes/Assessment Responsibility Cost Timeframe Increase the current cultural actives to promote Agencies at annual Health Fair college programs in support of Diverse Stu- Health Services Coordi- will represent a diversity of inter- $450 Fall 2006 dent Populations, including motivational nator ests. speakers from the GLBT community. Information is presented (monthly basis) con- Monthly displays are completed cerning various Wellness Issues, such as ex- Health Services Coordi- Budgeted and posted in the display case in Ongoing 2006-2007 ercise, mental wellness and nutrition as it re- nator elsewhere A-building breezeway. lates to diverse campus groups. See attached. Reference: 1.1.2 Invite speakers who are representative of the targeted population. In addition, make the events campus-wide, and educate not only the “new students” but also the continuing/native-born/English speaking students, faculty and staff. 1.1.5 Develop alliances with Latino; Afghani; African-American; Ethiopian; Asian; Gay/Lesbian/Trans- Student Equity Plan, April 2005 (Also, see at- gender/ bi-sexual; and others and disability related community agencies, Chamber of Commerce and tached.) cultural centers to increase the awareness of higher education, retention in high school; and career goal setting. 2.1.5 Expand and support student activities (i.e. Black History month, Cinco de Mayo, Asian New Year, Disability Awareness Day, etc.) and increase the number of student clubs, in order to promote the visibility of ethnically diverse or different groups.

Improve student persistence, retention and completion rates to increase student success, particularly for educational and eco- College of Alameda Strategic Direction: nomically at-risk students.

College Of Alameda Institutional Action Priority: Create a premier center for student support services, developmental education, and foundation skills.

Goal: Provide opportunities for students that address health and wellness issues affecting their ability to succeed.

Objective: Below outcomes/assessment are evaluated; services are improved.

Activities/Tasks Outcomes/Assessment Responsibility Cost Timeframe

Develop an effective drug and alcohol information and Health Services Coordinator in cessation program on campus. Survey data is compiled and outcome de- conjunction with Student Activi- termines the nature of the program devel- $600 Fall 2007 ties, Cal Works and COA Safety oped. Committee. Continuance of monthly family planning/STD clinics. Success = the number of students who are referred for Planned Parenthood ser- Health Services Coordinator $300 2007-2008 vices are increased over previous year.

Health And Fitness Agencies are present at the annual Health Fair Committee, with A variety of agencies are represented. $1300 Fall 2007 Health Fair. Health Services Coordinator

Work to promote a student-driven gay/straight alliance on campus, in support of Diverse Student Populations. Health Services Coordinator Organization will be institutionalized and with Student Activities and inter- $300 2007-2008 provide a safe environment for students. ested students, staff and faculty. Integrated Budget Planning 2007-2008

College of Alameda Strategic Direction: Promote educational innovation, encouraging risk taking behavior and engaged global citizenship.

College Of Alameda Institutional Action Priorities: Use technology to improve student success, distance learning opportunities, and COA’s website.

Goal: Health Services Web Site is current, holistic, and in compliance with state, district and college mandates.

Activities/Tasks Outcomes/Assessment Responsibility Cost Timeframe

HSC is responsive to new state/district/college regulations and policies. Web page is used as a communication de- Web pages are current. Health Services Coordinator 0 2007-2008 vise for all constituencies. Monitor/DVD player is installed in waiting Alternate media is used to communicate with students. room of Health Services Center. Health Health Services Coordinator $1200 Fall 2007 Education videos are easily available.

College of Alameda Strategic Direction: Develop a culture of inquiry to support institutional effectiveness and student success.

Develop student learning outcomes and implement integrated strategic planning, leading to decision that incorporate data driven College Of Alameda Institutional Action Priorities: by educational priorities.

Goal: Increases student awareness of health and illness.

Objective: Students learn about tuberculosis and eye wellness.

Activities/Tasks Outcomes/Assessment Responsibility Cost Timeframe After receiving a Tuberculosis Screening Test, clients will Pre and post testing. Success = a signifi- demonstrate an increased understanding of the meaning of cant improvement in scores between the Health Services Coordinator $350 Ongoing 2007-2008 the skin test, TB disease transmission and the difference pre-test and post-test. between TB disease and TB infection. After participation in the Eye Care Clinic, clients will Pre and post testing. Success = a signifi- demonstrate increased understanding of selected eye dis- cant improvement in scores between the Health Services Coordinator $200 Ongoing 2007-2008 eases, and measures to take that foster wellness. pre-test and post-test.

Provide accessible and responsive educational opportunities within a supportive, caring, inviting and safe environment for all of College of Alameda Strategic Direction: the college’s constituencies.

College Of Alameda Institutional Action Priorities: Use Measure A funds to provide an updated, safe, clean working and learning environment.

Goal: Health Services has contributed knowledge and expertise to complement College’s development of safety policies and procedures.

Activities/Tasks Outcomes/Assessment Responsibility Cost Timeframe All necessary equipment and supplies are purchased to Health Services facility is a model for oth- Health Services Coordinator complement new Health Services facility. er district colleges and adequately serves with Dean and/or VP of Student $950 the needs of students within a given bud- Services. get. All necessary policies and procedures regarding the day- All necessary policies and procedures for Health Services Coordinator to-day operations of Health Services are written and sub- Health Services have been completed and with Dean and/or VP of Student $100 mitted for approval. approved. Services. Smoking policy is published and evident to students, faculty and staff. Smoking cessation counseling has been of- COA Smoking Policy has been implement- HSC with COA managers and $300 fered. ed. Safety Committee.

The Health Services Sexual Assault Policy (from the Information regarding PCCD Sexual As- PCCD Sexual Assault Policy) will be sault Policy disseminated to faculty, staff $200 Fall 2007 executed. and students. Volunteers willing to do peer counseling for victims of dat- A peer group for victims of dating vio- Health Services Coordinator in ing violence, rape, sexual assault, domestic violence, and lence, rape, sexual assault, domestic vio- collaboration whit the Director of $150 Fall 2007 stalking crimes will be sought. A program will be estab- lence, and stalking crimes is established. Student Activities lished.

44 References: References: Reference #1 No references to Health Services were found in the Accreditation Self-Study. Accreditation Self-study, Spring 2003  Analyze the need to implement a student health services fee: A district-wide student survey was done in Spring 2002. Results have been tabulated, though not yet analyzed. The initial results reflect positively on the implementation of a fee. The researcher has been contacted and it is expected that the completed summary will be available soon. However, as the state-wide budget crisis has already impacted students  Analyze the need for mental health and other health practitioners: College of Alameda Health Services currently collects statistics regarding Health Service usage. Discussion with the other Health Service Coordinators at the other campuses has led us to believe that we can more appropriately serve students and maintain fiscal responsibility by spreading shared serves over all four campuses. To this end, we are Reference #2 working to standardize our statistics collection and determine usage as a district. Ad- Education Plan, 2004-2019, pages 263-265 ditionally, through the use of resources in other areas and through grants received on some campuses, some of the necessary services area being offered at this time (e.g. limited hour mental health practitioner through CalWORKs at COA).  A dental screening clinic is planned for Fall 2003, with discussion underway to determine the feasibility of the establishment of an ongoing dental “externship” program by the University of the Pacific, specifically to address the dental needs of PCCD students.  Clerical personnel or work-study student should be considered when the move to the F-building is completed.  As responsibilities of the College Nurse have been broadened, it is planned to change the title to Health Services Coordinator. 1.1.2 Invite speakers who are representative of the targeted population. In addition, make the events campus-wide, and educate not only the “new students” but also the continuing/native-born/English speaking students, faculty and staff. 1.1.5 Develop alliances with Latino; Afghani; African-American; Ethiopian; Asian; Gay/Les- Reference #3 bian/Transgender/ bi-sexual; and others and disability related community agencies, Cham- Student Equity Plan, April 2005 ber of Commerce and cultural centers to increase the awareness of higher education, retention in high school; and career goal setting. 2.1.5 Expand and support student activities (i.e. Black History month, Cinco de Mayo, Asian New Year, Disability Awareness Day, etc.) and increase the number of student clubs, in order to promote the visibility of ethnically diverse or different groups. Reference #4 See attached. Student Learning Outcomes Reference #5 Pending (Spring 2007) Program Review Reference #6 Drug Free School and Communities Act of 1986 State/Federal Regulations Part 86, the Drug-Free Schools and Campuses Regulations, requires that, as a condition of re ceiving funds or any other form of financial assistance under any federal program, an institution of higher 45 education (IHE) must certify that it has adopted and implemented a program to prevent the un- lawful possession, use, or distribution of illicit drugs and alcohol by students and employees. If audited, failure to comply with the Drug-Free Schools and Campuses Regulations may cause an institution to forfeit eligibility for federal funding. 2.1 Provide students and potential student with information concerning college programs, ser vices, financial assistance, facilities and grounds, academic expectation, course scheduling, Reference #7 and institutional procedures in a timely manner. (sex assault, health services, alcohol and Matriculation Plan other drugs)

46 COA Needs Assessment Survey

What Do Students Want?

In order to serve students better in the Health Services Center at the College of Alameda, we need to know WHAT YOU WANT in the way of programs and services. Please take a few min- utes to help us.

I would like more information on the follow- I would like to see the following semester length ing: classes offered for credit:

 AIDS  Weight Management And Exercise  Quitting Smoking  Anger Management , Stress And Anxiety  Exercise And Diet Reduction  Healthy Lifestyles  Sexual Behavior, Birth Control, Sexually  Depression Transmitted Diseases  Colds And Flu  Alternative Medicine, Preventive Medicine,  Anger Management Nutrition And Fitness  Tuberculosis  Drugs And Alcohol  Sexually Transmitted Diseases  Political Health Issues: Universal Health  Birth Control/Family Planning Coverage, Managed Care, Health Ethics,  Stress Reduction Consumerism  High Blood Pressure  Other/ Please Explain:  Diabetes  Other/Please Explain:

I would like to see the following one day programs:

 Eye Exams I would like the following services of-  Dental Clinic fered at the Health Services Center:  Health Fair  Flu Shots  Testing For Sexually Transmitted Dis-  Blood Drive eases  AIDS Awareness  Testing For HIV  Stress Reduction  Pregnancy Testing  Student Disability Awareness  TB Testing  Blood Pressure Control  Other/ Please Explain:  Other/ Please Explain:

47 48 COA Needs Assessment Survey Summary 2002-2003

Information Yes Percent Posi- tive Response AIDS 35 38% Quitting Smok- 22 24% ing Exercise And 41 45% Diet Healthy Life- 33 36% styles Depression 24 26% Colds And Flu 25 27% Anger Manage- 31 34% ment Tuberculosis 20 22% Sexually Trans- 36 39% mitted Diseases Birth 27 29% Control/Family Planning Stress Reduc- 41 45% tion High Blood Pres- 19 21% sure Diabetes 16 17% Quitting Drinking 1 1% Written comment Suicide 1 1% Written comment Sexuality 1 1% Written comment Services Testing For Sex- 59 64% ually Transmit- ted Diseases Testing For HIV 50 54% Pregnancy Test- 50 54% ing TB Testing 45 49% Semester Classes Weight Manage- 42 46% ment And Exer- cise Anger Manage- 35 38% 49 ment , Stress And Anxiety Re- duction Sexual Behavior, 43 47% Birth Control, Sexually Trans- mitted Diseases Alternative 37 40% Medicine, Pre- ventive Medicine, Nutri- tion And Fitness

Drugs And Alco- 34 37% hol Political Health 32 35% Issues: Univer- sal Health Cov- erage, Managed Care, Health Ethics, Con- sumerism One Day Pro- grams Eye Exams 50 54% Dental Clinic 44 48% Health Fair 40 43% Flu Shots 33 36% Blood Drive 42 46% AIDS Awareness 41 45% Stress Reduc- 47 51% tion Student Disabili- 25 27% ty Awareness Blood Pressure 24 26% Control

Top ranking items for “Information Wanted:”

1. Exercise and Diet 45% 2. Stress Reduction 45% 3. Sexually Transmitted Disease 39% 4. AIDS 38% 5. Healthy Lifestyles 36% 6. Anger Management 34%

50 Top ranking items for “Services:”

1. Testing for STDs 64% 2. Testing for HIV 54% 3. Testing for Pregnancy54% 4. TB Testing 49%

Top ranking items for “Semester Length Class:”

1. Sexual Behavior, etc 47% 2. Weight Management, etc 46% 3. Alternative Medicine, etc. 40% 4. Anger Management, etc. 38% 5. Drugs and Alcohol 37% 6. Politics of Health, etc. 35%

Top ranking items for “One Day Programs:”

1. Eye Exams 54% 2. Stress Reduction 51% 3. Dental Clinic 48% 4. Blood Drive 46% 5. AIDS Awareness 45% 6. Health Fair 43%

51 52 Discussion of Peralta Health Fee Survey 2002

The 30-43% of the student population that is uninsured is a cause of concern. What still remains unclear is what the composition of this population is. If this is a group who statistically needs more frequent medical services, then a health fee to address these needs might be considered. If this is a group of healthy 18-22 year olds who normally would not see a physician for a several year period, then the conclusions regarding the need for a health fee would differ.

Although 82% of the students surveyed wanted health care at their respective colleges, I believe we can generally agree that everyone would like health care services at the location where they spend most of their time. I have difficulty determining what the survey in- dicates about “wants” versus “needs. “

The 30% of students whose health problems and stress cause them to lag behind in their studies is also a concern. However, it is unclear that these problems and stress can be eliminated or ameliorated by providing on-campus health services.

If a health fee is being considered to bring the Peralta Community College District on a par with other community colleges in the state, and therefore acts as a marketing tool to make the district more competitive, then a health fee may be appropriate.

Although the survey states that “The questions were tested for validity issues and worded to eliminate leading or biased questions,” the following are concerns:

2. Questionnaire composition: a. Question #1: suggests a need for counseling not medical services. b. Question #2: makes the assumption that services are wanted. c. Question #4: assumes the services are wanted. 3. Conclusion: the results of the survey indicate that only approximately 25 % of students have health concerns that affect their performance in their classes. “A significant majority of surveyed students want health services provided to them on campus” assumes that students want health services, and does not offer the choice “If you want health services, would you want services at this college?” 4. Table 5: Evaluators should consider what impact a fee at each level will make and what health services currently cost. 5. Table 6: Is the data misleading because students can indicate multiple services? 6. Table 7: If the main health concerns are those choices in Table 6, is it consistent to then ask about services that reflect health concerns re: doctor’s visits, women’s health etc.? 7. Other considerations: Demographic data seem to have been under-utilized. Who, in terms of age and course load, are the people who have no coverage? Are they healthy 18 – 22 year olds who statistically have few health problems? Do the most at-risk students (“28% who said that health problems or stress had caused them to fall being in their students”) have health coverage or not?

53 54 Basic Demographics Students Receiving Health Services 2004-2006

55 56 57 58 Healthy Campus 2010

Healthy Campus 2010 establishes national college health objectives and serves as a basis for developing plans to improve student health. The ACHA manual, Healthy Campus: Making It Happen, is a companion document to Healthy People 2010, the nationwide health promotion and disease agenda, and similarly, was developed through a broad consultation process built on the best scientific knowledge.

Health Objectives Healthy Campus 2010 has planning guidelines and over 200 health objectives with baselines and targets for the nation's colleges and universities to achieve over the next decade. The Leading Health Indicators reflect the major public health concerns in the United States and were chosen based on their ability to motivate action, the availability of data to measure their progress, and their relevance as broad public health issues.

The Leading Health Indicators are: 1. Physical Activity 2. Overweight and Obesity 3. Tobacco Use 4. Substance Abuse 5. Responsible Sexual Behavior 6. Mental Health 7. Injury and Violence 8. Environmental Quality 9. Immunization 10. Access to Health Care

A Healthy Foundation Healthy People 2010 can provide a foundation for shaping future health plans for institutions of higher education and serves as:  A matrix, linking governmental agencies, state and local health departments, communities, schools, businesses, health care services, and institutions of higher education, to improve physical, social, and environmental health.  A strategic planning tool for campus communities to define future health priorities of students, faculty, and staff.  A program and curriculum guide for degree oriented and continuing education programs, including schools of medicine, public health, and allied health personnel.  A guide for future grant, program, and service funding priorities from federal and state govern- ments for the next decade.  A model for administrators, faculty, staff, and students to develop healthy campus environments, and direct services and support toward health enhancing behaviors within a campus community.

59 60 PCCD Student Evaluation of College Nurse

61 62 PCCD Evaluee’s Self-Evaluation Report