Correlates of and barriers to COVID-19 vaccine initiation and intention among US college students.

OBJECTIVE: To examine correlates of and barriers to COVID-19 vaccine initiation and intention among college students. PARTICIPANTS: 1,171 students attending a public university in the South. METHODS: Multivariate logistic regression was used to assess the correlates of vaccine intention and initiation. Reasons for pursuing or foregoing vaccination were analyzed qualitatively using an inductive approach. RESULTS: Among respondents, 44% had initiated vaccination, 38% intended to be vaccinated, and 18% were unsure about/unwilling to be vaccinated. Vaccine initiation and intention were both associated with 2019-2020 seasonal flu vaccination and political ideology, with conservative-leaning students having lower odds of vaccine initiation and of intention relative to liberal-leaning students. The most common reasons for vaccine initiation/intention and for vaccine hesitancy differed in frequency by political ideology. CONCLUSION: The most effective vaccine promotion strategies may be those tailored to different social groups, virus-related beliefs/perceptions, and the specific concerns of vaccine hesitant students.

Encountering Overdose: Examining the Contexts and Correlates of US College Students' Overdose Experiences.

BACKGROUND: As overdose rates increase, it is critical to better understand the causes and contexts of overdose, particularly for college students who exhibit high rates of alcohol and drug use. The purpose of this study was to examine the social contexts of U.S. college students' overdose experiences (their own, witnessed, and family'/friends'), and to assess the correlates of personal overdose. METHODS: A cross-sectional survey containing open- and closed-ended questions about overdose encounters was completed by undergraduate students at a southeastern American university (n = 1,236). Descriptive frequencies assessed prevalence, substance involvement, and fatalities associated with different encounter types. A content analysis of open-ended responses examined the social contexts of encounters. Multivariate logistic regression was used to assess the correlates of personal overdose. RESULTS: Forty-one percent of respondents reported at least one type of overdose encounter and witnessed overdose was most common. Substances involved varied across encounter type and 20-40% of respondents reported overdose-related fatalities. Students who encountered overdose often reported multiple experiences and many attributed overdoses to mixing substances. Respondents commonly encountered overdose as intervening bystanders and overdose events were often perceived to be intentional or the result of using substances to cope with stress/mental health concerns. Personal overdose was significantly associated with having ever mixed alcohol with prescription drugs, been diagnosed with a mental disorder, witnessed an overdose, and had a family member/friend overdose. CONCLUSION: Findings suggest a need for future research into the contexts and consequences of students' overdose encounters to more effectively tailor overdose prevention/response initiatives within college communities.

Applying the health belief model to examine college students' early stage adoption of non-pharmaceutical interventions in response to COVID-19.

OBJECTIVE: Amidst the COVID-19 pandemic, colleges worked to minimize transmission through non-pharmaceutical interventions (NPIs). The objective of this study was to apply the Health Belief Model to assess correlates of US college students' early stage NPI uptake. PARTICIPANTS: Sample includes 1,223 students from a medium-sized university who participated in an anonymous health survey. METHODS: Logistic regression assessed associations between HBM factors and consistent adoption of five individual NPI strategies. Multivariate linear regression assessed HBM correlates of NPI adoption overall. RESULTS: Correlates of NPI uptake varied by strategy. Only perceived NPI benefits were significantly associated with NPI adoption individually and overall. Perceived susceptibility was associated with use of hand sanitizer, facemasks, and general NPI adoption. Perceived severity was associated with avoidance of large social gatherings only. CONCLUSION: The HBM appears valuable for understanding students' NPI adoption. Results suggest university health initiatives should prioritize education on the efficacy of particular preventive behaviors.

Illicit drug use among college students: The role of social norms and risk perceptions.

PURPOSE: To examine the prevalence and correlates of college student use of illicit substances including cocaine, designer drugs, and nonmedical use of prescription stimulants and opioids, and to identify how different drug-related perceptions are related to past year use of these substances. METHODS: Data were analyzed from a cross-sectional anonymous web-based survey among a sample (n = 1345, 81% female) of students attending a mid-sized liberal arts college in the US. Logistic regression models were estimated to assess the relationships between substance-specific descriptive norms, injunctive norms, perceived availability, risk perceptions and past year use of cocaine, designer drugs, prescription stimulants, and opioids, adjusting for current marijuana use, alcohol dependence, sensation seeking, and sociodemographic factors. FINDINGS: Past year use of illicit substances ranged from 6% for nonmedical prescription opioids to 21% for nonmedical prescription stimulants. The sociodemographic correlates past year substance use differed by substance type. Descriptive norms (perceptions of peer use) and perceived risk were not consistently related to use of these substances. Current marijuana use was the strongest correlate across substances, and both injunctive norms (perceptions of peer approval) and perceived availability were consistently related to use of each substance. CONCLUSIONS: Findings suggest that future college student drug prevention efforts should more directly target current marijuana users since they are most at risk of using other illicit substances. Additionally, findings indicate that injunctive norms may be an important consideration for education-focused drug prevention programs. However, findings should be interpreted in light of limitations of the sample, which is predominantly female.