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Health concerns and needs of nontraditional women students at a rural southern university.

The purpose of this study was to determine the major health concerns and services needed by nontraditional women students at a rural southern university. A convenience sample of 55 participants with a mean age of 34 years enrolled in summer school courses completed a needs assessment regarding their health concerns and services. The majority of students reported having no health insurance and no preventative screening tests in the past year. Other health issues deemed important included assertiveness training and self-defense for women. Substance abuse, addiction, disordered eating and depression were considered least important. Services identified by nontraditionai women students as most important may be different than those of their younger counterparts. Although some services are appropriate for all students regardless of age and life experience, other services targeting special needs of this group could enhance their health status and progress toward a degree.

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One of the fastest growing student groups in higher education is the "nontraditional" woman student, who typically enters college after the age of 25, or returns to college after a period of absence. A 1988 College Board survey indicated that 45% of the student body was older than 25 years of age and of these older students, nearly two-thirds of them were women (Hirschorn, 1988). According to Brazziel (1989) adults constitute the fastest growing segment of all the population groups in higher education; particularly women students.

Although women who return to school are usually highly motivated to complete degrees, their transition from a work or home environment to academics is not without its problems (Rifenbary, 1995). Many women students return to school as part of a reassessment of their lives, which is often indicative of a larger transition in life.

The problems encountered by nontraditional students may be quite different than traditional-aged students who enter college immediately following graduation from high school. Some of the difficulties reported by women which serve as barriers to the completion of a degree include child care issues, financial concerns, multiple role demands, and a lack of confidence in preparation and the skills needed to successfully meet graduation requirements (Christensen & Kime, 1994; Hanniford & Sagaria, 1994).

One of the ways nontraditional students differ from other groups on campus may be related to the kind of health education services they need. A broad range of health concerns such as preventative health screenings, gynecological care, child care, and counseling services for academic and personal support are often mentioned as important issues for nontraditional students.

No studies were found that directly assessed the health education service needs of nontraditional women students. However, some studies provided indirect support that mature students often experience anxiety upon returning to school associated with guilt because of family responsibilities (Hooper, 1979), concerns about the quality and expense of childcare (Terrell, 1990), or changes in their roles as wife and/or mother.

Because health issues and the stresses associated with personal responsibilities may be reasons nontraditional students drop out of college (Hanniford & Sagaria, 1994), universities need to be sensitive to the services that address the special needs of this group. "Retention of nontraditional students can be accomplished successfully if support services are available" (New York Occupational Education Equity Center, 1994, p. 5).

Methods

Participants in the Study

Questionnaires were administered to a sample of 55 nontraditional women students at a rural Southern University who volunteered to participate in the study. All participants were aged 25 or over, who were enrolled in summer school and either just beginning college or reentering after a period of absence.

Health Service Needs Assessment Protocol

Needs assessment is a process for gathering useful information to plan for individual students and groups (Gilmore & Campbell, 1996). A 105 item questionnaire was designed to assess the health education service needs of nontraditional women students in the following areas: Physical Health, Emotional Health, Social/Environmental Health, and Preventative Health.

Questions included an assessment of the students' physical activity needs, a nutritional evaluation, stress management strategies, perceived counseling needs, and access to preventive health services. The instrument was piloted with 12 nontraditional women students and the results were used to revise questions that were not clear or needed additional response options. Data from the pilot test participants were not included in the results.

Procedures

Students enrolled in classes were asked to complete the survey. This resulted in a relatively small sample as most classes only had a few students classified as nontraditional (approximatley 23% of all women students over the age of 25 enrolled in summer school). When possible the students completed the questionnaire immediately following the class. If this was not possible they were instructed to complete the questionnaire prior to the next class and return it to the instructor at the beginning of the next session. The results were analyzed using the SPSS statistical package.

Results

Description of Participants

The majority (80%) of the nontraditional women students described themselves as Caucasian and approximately 15% were African American. The average age of the sample was 34.6 years. The modal income for the group was less than or equal to $15,000. Nearly two-thirds of the participants reported they were married and most likely to have two children living with them for whom they provided financial support.

Nearly 50% of the participants were classified as seniors and approximately 20% were freshmen. Two distinct patterns emerged with reference to the age of entry into college. Either the nontraditional women started college at a traditional age (39%) and returned after a period of absence, or they entered when whey were 25 years of age or older (37%). About 30% of the students had been attending college for 5 to 6 years and about 25% had been there 3 to 4 years.

Progress Toward A Degree

The majority of the students had been attending school continuously without missing a semester, and approximately 25% had a gap of 3 or more years in pursuit of their education. Forty-seven percent were enrolled in 12 hours or more and were classified as full-time students. About 31% of the students reported having a GPA between 3.5 and 4.0, and about the same percentage reported a GPA between 3.0 and 3.49.

Nearly two-thirds were receiving financial aid to attend school and most of this aid was in the form of state or federal education loans. Two factors most frequently identified as having interfered with progress towards degree completion were caretaking responsibilities for children (46%) and financial difficulty (39%). It is also notable that about a third of the students claimed that none of the responsibilities were a hindrance to their degrees.

Health Concerns

Health issues seemed to be a concern for nontraditional women students. When asked whether health was important enough to postpone other responsibilities in order to get health care, 58% said "yes," and an additional 29% said "sometimes." Fourteen percent rated their overall health "excellent," 53% "good," 22% "fair," and only 2% said their health was "poor."

Although 59% of the students surveyed said that good health was extremely important to their life, only about 66% of the students reported having health insurance. Those who had health insurance only 46% reported that health screening preventative tests were included in their coverage. Forth-six percent reported having health check-ups only when they are sick, and 34% said they have an annual health checkup. Eight-five percent said they had their blood pressure checked in the last year, 75% had a vision examination in the past 5 years, and 19% had their hearing checked in the same time period. Fifty-nine percent had their breasts examined by a health professional in the past year, and 49% reported they had performed a breast self-exam each month. Sixty-six percent said they had never had a mammogram. Fifty-one percent had a pap smear within the past year.

Health Behaviors

Thirty-seven percent of the participants said they rarely or never engage in regular exercise including activities such as walking, jogging, swimming, biking or aerobics for at least a minimum of 20 minutes. Approximately 32% of the participants reported engaging in such exercise 1 or 2 times per week, while 20% said they exercised 3 to 4 times per week. Forty-two percent reported not exercising on a regular basis. Of those participants who exercised regularly, approximately 20% had been doing so for less than 3 months and about the same percentage had been exercising for more than 1 year.

With regard to other aspects of health, 48% reported they had never smoked and another 22% said they had quit smoking. About 20% reported smoking up to 1 pack of cigarettes per day. One-third of the students reported that they were nondrinkers and 50% reported drinking on rare occasions. Those who reported drinking were most likely to drink between 1 and 2 drinks per week. In addition this particular group of college students rarely engaged in binge drinking, which is defined as 5 or more drinks at one sitting for men, and 4 or more for women.

Health Risk Factors

Approximately 36% of the women in the study did not know their cholesterol level and 46% described their cholesterol number as normal or below normal. About 71% said their blood pressure was normal or low. About 8% said they did not know their blood pressure. Fifty-nine percent reported having a close relative with heart disease or a heart attack. Seventy-six percent of the students claimed that they did not have any female relatives with a history of breast cancer, and about the same percent reported a family history free of breast cancer. Eighty-one percent said they had never been diagnosed with depression.

Health Safety Behaviors

These students typically travel between 10,000 and 15,000 miles per year, 15%

travel about 20,000 miles and an additional 15% travel over 20,000 miles. More than half (58%) of the students said they frequently drive the speed limit. Eighty-one percent said they would never ride in a car when the driver was intoxicated, and 85% said they never driven themselves when intoxicated.

Nutritional Choices

The majority of nontraditional students consume a mixture of high and low fat dairy products on a daily basis. They eat a mixture of red meats and poultry or fish and are likely to prepare food both the high and low fat way. Thirty-one percent reported eating 3 servings of fruits and vegetables per day, 24% eat 2 servings per day, and 12% eat 1 serving per day.

Thirty-seven percent said they eat fast food several times each week, and 40% said they eat it a few times each month. With respect to high fat snacking, 24% reported eating such snacks 1 to 2 times daily and 53% claim they eat high fat snacks a few times each week.

Availability of Services

The students were asked the question "Based on your experiences at the university, rate the importance of the availability of each of the following services to the completion of your degree." The participants answered this question on a 5 point Likert scale from A=Extremely Unimportant to E=Extremely Important. Table 1 shows the responses to this question. Availability of preventive health screenings, instruction on ways to access university resources and financial management/planning workshops were rated high in terms of importance. Also rated high were assertiveness training, self-defense for women and educational information about women's health issues. Services considered least important were counseling for substance abuse, addiction, disordered eating and depression. The bimodal nature of the responses to counseling for relationship abuse suggests that the participants are polarized in terms of how they view such counseling services.

Observations and Recommendations

The sample in this study, though not representative of the total nontraditional women student enrollment at the university, appears to mirror descriptions of this group in other studies (Hirschorn, 1988; Hooper, 1979). Nontraditional students typically have multiple demands on their time and energies, are often married with children, and have financial concerns with regard to their education.

Even with these demands, many are enrolled as full-time students and manage to earn a GPA of 3.0 or above, which is quite commendable. Understandably, it may take nontraditional students longer to complete their degrees than their traditional counterparts, as they might have begun school, left for a period of time, and returned at a later date to complete their education.

With regard to the health education needs of this group, it is of concern that nearly 30% of nontraditional women students have no health insurance. The policies offered by the university perhaps do not meet their needs and many may not be able to afford individual policies for themselves and their dependents.

Although many of these students had selected preventative health screening tests during the past year, this pattern was not consistently reported. Of particular concern was the percentage of women who reported that they had not had a mammogram or pap smear test during the past year. These types of tests are often cost prohibitive, particularly if one does not have any health insurance coverage at all or insurance that does not include payment for a yearly health preventative screening test.

The two areas of health behavior that nontraditional women students could improve are their levels of exercise and their nutritional habits. In this regard this sample is probably not much different from the rest of the student population or the population in general. The university does provide opportunities for students to become involved in physical activity in a variety of ways; enrollment in activity courses in the Department of Health and Human Performance, individual activities through the Intramural Recreation program such as aerobics, weight training and cardiovascular fitness training, and special events sponsored by organizations to participate in walks and runs. Although the campus design for exercise could be improved with additional walking paths and bike lanes, one is able to find a route on the campus for such activities.

A large percentage of the students consume diets that reflect the "fast food" syndrome. Time constraints promote "eating on the run" as opposed to cooking and consuming an adequate number of fruit and vegetable servings each day. The food service on campus seems to provide a great variety of such choices. It may be that nontraditional students are unaware of the food services on campus; other than perhaps the choices in the Student Union facility.

It seems that the services identified by nontraditional women students as most important may be different than for younger students. This population found it important to be able to access information pertinent to completing their degrees as well as having access to information specific to women's health issues. They were also concerned about assertiveness skills and their ability to in effect "take care of themselves." Perhaps workshops in both assertiveness skills training and self-defense for women could be offered on a regular basis.

As the percentage of nontraditional women students continues to increase at universities across the nation, it is important that this "silent" (perhaps soon to be majority) group provide input with regard to their needs. While some services are appropriate for all students regardless of age and life experience, other services targeting special needs of this group could greatly assist them in their academic pursuits.
Table 1

Importance of availability of services

Services                                                    A   B   C

Counseling services for depression                          25  14  22
Counseling services for disordered eating                   29  20  19
Counseling services for substance abuse and addiction       30  10  15
Counseling services for any form of relationship abuse      24  12  14
Seminars concerning physical fitness for adult women        14  19  29
Planned and monitored fitness activities                    10  15  32
Physical fitness assessment                                 10   9  32
Educational information on health issues that affect women  12   7  32
Assertiveness training for women                             9  15  22
Self defense for women                                      15  14  27
Financial management and planning courses/seminars           7  22  37
Classes concerning legal issues                             15  14  27
Time management classes                                      7   2  37
Conflict resolution information                              7  17  36
Instruction on how to access university resources            2   9  29
Information on preventive health screenings                 12  10  29

Services                                                        D   E

Counseling services for depression                              10  20
Counseling services for disordered eating                       10  14
Counseling services for substance abuse and addiction           14  22
Counseling services for any form of relationship abuse          14  29
Seminars concerning physical fitness for adult women             7  24
Planned and monitored fitness activities                        14  20
Physical fitness assessment                                     12  29
Educational information on health issues that affect women      10  29
Assertiveness training for women                                22  23
Self defense for women                                          19  17
Financial management and planning courses/seminars              10  15
Classes concerning legal issues                                 19  17
Time management classes                                         10  15
Conflict resolution information                                 17  15
Instruction on how to access university resources               22  31
Information on preventive health screenings                     20  20

Numbers represent percentages

A=Extremely Unimportant
B=Somewhat Unimportant
C=Important
D=Somewhat Important
E=Extremely Important

Note: Percentages do not add up to 100 because of missing or
incomplete data.


References

Brazziel, W.F. (1989). Older students. In A. Levine & Associates, Shaping higher education's future: Demographic realities and opportunities 1990-2000 (pp. 116-132). San Francisco: Jossey-Bass.

Christensen, P., & Kime, B. (1994). Climb on: From welfare to a degree. Eric Document 373 818.

Gilmore, G.D., & Campbell, M.D. (1996). Needs assessment strategies for health education and health promotion (2nd ed.). Madison: Brown & Benchmark.

Hanniford, B.E., & Sagaria, A.D. (1994). The impact of work and family roles on associate and baccalaureate degree completion among students in early childhood. Paper presented at the Annual Meeting of the American Educational Research Association, New Orleans, LA, April. Eric Document 370 520.

Hirschorn, M.W. (1988, March 30). Students over 25 found to make up 45 percent of campus enrollments. Chronicle of Higher Education, A35-A36. Hooper, J.O. (1979). Returning women students and their families: Support and conflict. Journal of College Student Personnel, 20, 145-152.

New York State Occupational Education Equity Center. (1994). Nontraditional careers-Making them a tradition. Eric Document 374 238.

Office of Institutional Research. (1997, July 18). Report of women students enrolled at Northwestern State University, Spring, 1997 semester.

Rifenbary, D. (1995). Reentering the academy: The voices of returning women students. Initiatives, 56(4), 1-10.

Terrell, P.S. (1990). Adapting institutions of higher ed to serve adult students' needs. NASPA Journal, 27, 241-247.
SUSAN MOLSTAD
NEELAM KHER
CATHERINE McMILLAN
Northwestern State University of Louisiana
COPYRIGHT 2001 Project Innovation (Alabama)
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2001 Gale, Cengage Learning. All rights reserved.

 
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Author:Molstad, Susan; Kher, Neelam; McMillan, Catherine
Publication:College Student Journal
Article Type:Statistical Data Included
Geographic Code:1USA
Date:Sep 1, 2001
Words:3057
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