Health check attendance association with health and study-related factors : a register-based cohort study of Finnish university entrants

Background: General health checks are an established component of preventive health care in many countries. Declining participation rates have raised concerns in health care providers. Understanding the reasons for attendance and non-attendance is necessary to improve the preventive health care system. The aim of this study was to examine health- and study-related factors associated with university entrants' health check attendance. Methods: Since 2009, an electronic health questionnaire (eHQ) has been conducted yearly to all Finnish university entrants by the Finnish Student Health Service (FSHS) to screen students for a general health check. The questionnaire comprises 26 questions about health, health habits and studying. The study population consisted of the 3346 entrants from the 2011-2012 academic year who were referred to a health check based on their eHQ responses. The eHQ data were linked with health check attendance information. Multivariable logistic regression was used to study the associations between the questionnaire responses and non-attendance of the health check. Results: Male sex (OR 1.6, 95% CI % 1.4-1.9) and low engagement with studies (OR 1.5, 95% CI 1.2-2.0) were the variables most strongly associated with non-attendance. Having low state of mind was negatively associated with health check non-attendance thus enhanced the health-check attendance (OR 0.6, 95% CI 0.5-0.8). Conclusions: The results suggest that providing health checks in student health care may serve as a way of reaching students with health concerns. However, motivating males and smokers to attend general health checks continue to be a challenge also in a university student population. That low engagement with studies associates with health check non-attendance points to need to improve collaboration between universities and student health care.Peer reviewe

Screening University Students for Health Checks With an Electronic Health Questionnaire in Finland : Protocol for a Retrospective, Register-Based Cohort Study

Background: Health questionnaires and health checks are an established part of preventive health care services in Finland. However, only very limited research of these has been conducted. The Finnish Student Health Service (FSHS) provides primary health care services to all bachelor's and master's degree university students (approximately 134,500 students) in Finland. FSHS's statutory health examination process of university entrants includes an electronic health questionnaire (eHQ) and, based on the students' eHQ responses, a subsequent health check if necessary. To our knowledge, no previous studies have been published on the use of questionnaires for screening students for general health checks. Objective: The general aim of the study is to evaluate the health examination process of university entrants. The objectives are to determine how students' self-reported health in the eHQ and participation in the health examination process are associated with graduation, mental health problems, and the use of student health care services. Methods: This is an ongoing, nationwide, retrospective, register-based cohort study with a 6-year follow-up. The study population is the cohort of university entrants (N=15,723) from the 2011-2012 academic year. These students were sent the eHQ, which consisted of 26 questions about health, health habits, social relations, and studying. Based on the eHQ responses, students were referred to one of the following interventions: (1) a health check, (2) an appointment other than a health check (eg, physiotherapy), or (3) electronic feedback to support a healthy lifestyle, when the other interventions were not necessary. Multiple comparisons will be made within these groups using logistic regression. The primary outcome variables are graduation, having a mental health problem, and attending a health check. The use of FSHS health care services will be studied with the cluster analysis method. The data have been obtained from three nationwide registers: the eHQ register, the medical records of FSHS, and the Higher education achievement register. The data have been linked using personal identity codes. Results: As of August 2019, the data collection and processing are complete and the statistical analyses are in progress. Preliminary results are expected in autumn 2019. Further publications are expected in 2020, and two PhD theses are expected to be completed by the end of 2022. Conclusions: Studying practical procedures in primary health care is highly important for resource allocation and the development of evidence-based processes. This study will be the first to assess the usage of a health questionnaire in screening students for health checks. The findings of this study will contribute to the field of preventive health care. The main practical implication is the development of the FSHS's health examination process. We hypothesize that participation in the health examination process enhances academic achievement and the detection of university students' mental health problems early on in their studies.Peer reviewe

Guide för studerandehälsovården 2021

Studerandehälsovården ordnar hälso- och sjukvård för studerande och främjar studerandes hälsa och studieförmåga samt välbefinnandet i studiemiljön och studerandegemenskapen. Ändringar i den lagstiftning som styr verksamheten samt en förändrad verksamhetsmiljö har medfört ett behov av nya anvisningar, och därför publicerades denna guide våren 2020 och uppdaterades i början av 2021. I guiden presenteras studerandehälsovårdens lagstadgade uppgifter. Dessutom innehåller guiden anvisningar för det praktiska genomförandet av dessa och rekommendationer om bästa praxis. I guiden specificeras särskilt innehållet i hälso- och sjukvårdstjänsterna, definitionen av studerande som är berättigade till studerandehälsovård, statistikföringen, de hälsogranskningar som görs enligt exponeringen i arbetet, praxis vid behov av särskilt stöd samt tjänsterna för internationella studerande. I innehållet tas hänsyn även till att yrkeshögskolestuderande kommer att omfattas av Studenternas hälsovårdsstiftelses tjänster samt till ändringen av 17 § i hälso- och sjukvårdslagen. Vid uppdateringen av guiden 2021 kompletterades guiden med rekommendationer för personaldimensionering av hälsovårdare och läkare. Syftet med guiden är att stärka den samlade studerandehälsovården och förenhetliga praxis inom den på olika håll i landet. Guiden för studerandehälsovården är avsedd i synnerhet för yrkespersoner och ansvarspersoner inom studerandehälsovården för andra stadiet och högskolorna, men även för beslutsfattare och samarbetspartner

Association between university students' two-staged health screening and student health care utilisation : register based observational study

Objectives The aim of this study was to explore how university students' participation in a two-staged health screening at the beginning of university studies associates with student health care utilisation in a 6-year follow-up. Design Nationwide, observational, register-based cohort study with a 6-year follow-up. Setting Student health care in Finland. Finnish Student Health Service (FSHS) provides statutory student health services to university students in Finland. The two-staged health screening of FSHS includes the electronic health questionnaire (eHQ) provided annually to university entrants and a subsequent health check, when necessary, based on students eHQ response. Participants A national cohort of university entrants from the 2011-2012 academic year (N=15 723) was assessed. After exclusions the study population consisted of 12 972 students, n (female)=7368, n (male)=5604. Outcome measures The primary outcome measures were students' health service utilisation pattern obtained by clustering analyses method and the students' participation in different stages of the health examination process. Results Four distinguishable health care utilisation patterns were identified: (1) constant low use, (2) constant high use, (3) increasing use and (4) decreasing use. The students' OR for belonging to the constant high use group was significantly higher among females (OR 4.0, 95% CI 3.5 to 4.6) and students who attended the health check (OR 4.7, 95% CI 3.9 to 5.6). Conclusions Participating in the two-staged health screening was associated with increase in health care utilisation. The process detects students with health problems.Peer reviewe

Psychological Distress, Dental Health, and Dental Fear among Finnish University Students: A National Survey

The aim of this study was to study the association between dental fear, psychologicaldistress, and perceived symptoms of teeth controlled for age, gender, educational sector, andtobacco use. The data from the Finnish University Student Health Survey 2016 targeting students (n= 10,000) of academic universities and universities of applied sciences were used.  Psychologicaldistress was measured with the Clinical Outcomes in Routine Evaluation 10 (CORE-10) and the GeneralHealth Questionnaire 12 (GHQ-12) and dental fear with the question ‘Do you feel scared aboutreceiving dental care?’. The study included 3110 students. In logistic regression analyses thosewith psychological distress (measured with CORE-10 and GHQ-12) and those reporting teeth-relatedsymptoms were more likely than their counterparts to have high dental fear.  In gender-specificanalyses men with psychological distress (measured with CORE-10) and women with teeth-relatedsymptoms were more likely to have high levels of dental fear.  Finnish university students withpsychological distress and teeth-related symptoms were more likely to experience higher levels ofdental fear than their counterparts were.  The results of this study support possible commonvulnerability factors that dental fear and other psychological disorders may share.</p

Terveyttä edistävään ruokavalioon yhteydessä olevat tekijät korkeakouluopiskelijoilla

Korkeakouluopiskelijoiden terveystutkimuksessa on selvitetty alle 35-vuotiaiden perustutkintoa suorittavien suomalaisten korkeakouluopiskelijoiden terveys- ja ruokailutottumuksia joka neljäs vuosi vuodesta 2000 alkaen. Vuoden 2012 tutkimuksessa selvitettiin ensimmäistä kertaa ruokavalion laatua kokonaisuutena. Tämän artikkelin tavoitteena on kuvata yliopisto- ja ammattikorkeakouluopiskelijoiden ruokavalion laatua ja ravitsemussuositusten mukaisen, terveyttä edistävän ruokavalion toteutumista painoindeksin, terveystietoisuuden, koetun terveyden, toimeentulon ja pääaterian syöntipaikan mukaan sukupuolittain. Korkeakouluopiskelijoiden terveystutkimus toteutettiin vuonna 2012 lomakekyselynä postitse, mutta vastaaminen oli mahdollista myös internetissä. Opiskelijoiden ruokavalion laatua selvitettiin ravitsemussuositusten mukaisen, terveyttä edistävän ruokavalion toteutumista kuvaavalla ravintomittarilla (Index of Diet Quality, IDQ ). Kyselyyn vastasi yhteensä 4403 (44 %) opiskelijaa. Ravitsemussuositusten mukainen, terveyttä edistävä ruokavalio toteutui naisilla useammin kuin miehillä ja yliopisto-opiskelijoilla useammin kuin ammattikorkeakouluopiskelijoilla. Ylipainoisilla ja lihavilla oli suurempi riski epäterveelliseen ruokavalioon normaalipainoisiin verrattuna. Terveyttä edistävän ruokavalion toteutuminen ja siten parempi ruokavalion laatu liittyivät yliopistossa opiskeluun, opiskelijoiden normaalipainoisuuteen, terveystietoisuuteen ruokailun suhteen, hyvään koettuun terveyteen, hyvään toimeentuloon sekä pääaterian syömiseen opiskelija- tai työpaikkaravintolassa. Terveystietoisuus ruokavalion suhteen, sukupuoli ja korkeakoulusektori ovat yhteydessä terveyttä edistävän ruokavalion toteutumiseen. Ruuan terveellisyyden ajattelu sen hankintatilanteessa oli merkittävin opiskelijoiden ruokavalion laatuun yhteydessä oleva tekijä. Lisäksi ali- ja ylipainoisuus oli yhteydessä heikompaan ruokavalion laatuun. Pääaterian nauttiminen opiskelija- tai työpaikkaravintolassa paransi opiskelijoiden ruokavalion laatua, joten opiskelijoiden ruokailua opiskelijaruokaloissa tulisi edistää ja tukea

Association between dental fear and eating disorders and Body Mass Index among Finnish university students: a national survey

Background: Little is known about the association between eating disorders (ED) and dental fear. This study inves- tigated the association between dental fear and EDs through body mass index (BMI), and SCOFF (sick, control, one stone, fat, food) questionnaire among Finnish university students. We hypothesised that dental fear is associated with EDs and BMI.Methods:  We used the latest data from the Finnish University Student Health Survey 2016. This survey targeted undergraduate Finnish students (n     10,000) of academic universities and universities of applied sciences. We enquired about e.g. age, gender, height, weight, educational sector and perceived mental well-being. We used the SCOFF questionnaire to assess those at risk for developing EDs. The question ‘Do you feel scared about dental care?’ enquired about dental fear. We used the chi-square test and gender-specific logistic regression to analyse the associations between dental fear, EDs and BMI controlling for age, educational sector and mental well-being.Results:  In total, 3110 students participated in the study. Overall 7.2% of the students reported high dental fear and 9.2% scored SCOFF positive; more women than men reported high dental fear (11.2% vs. 3.8%, pthe association between dental fear and EDs and BMI. Among females, when controlling for educational sector and BMI, those with positive SCOFF score were more likely to have high dental fear than those with negative SCOFF score (OR 1.6; CI 1.0–2.4). After adding perceived mental well-being to the gender-specific regression analyses, overweight and obese males, BMI ≥ 25 (OR 2.4; CI 1.3–4.4) and females with poor to moderate mental well-being (OR 2.1; CI 1.4–2.9) were more likely than their counterparts to have high dental fear.Conclusions:  Among the Finnish university students BMI in males and problems of mental well-being in females were positively associated with high dental fear. The results of this study support possible common vulnerability factors that dental fear and other psychological disorders may share.</p

Users and non-users of web-based health advice service among Finnish university students – chronic conditions and self-reported health status (a cross-sectional study)

<p>Abstract</p> <p>Background</p> <p>The Internet is increasingly used by citizens as source of health information. Young, highly educated adults use the Internet frequently to search for health-related information. Our study explores whether reported chronic conditions or self-reported health status differed among Finnish university students using the Finnish Student Health Services web-based health advice service compared with those not using the service.</p> <p>Methods</p> <p>Cross-sectional study performed by a national postal survey in 2004. Material: A random sample (n = 5 030) of a population of 101 805 undergraduate Finnish university students aged 19–35. The response rate: 63% (n = 3 153). Main outcome measures: Proportion of university students reporting use a of web-based health advice service, diagnosed chronic conditions, and self-reported health status of users and non-users of a web-based health advice service. Statistical methods: Data were presented with frequency distributions and cross-tabulations and the χ²test was used.</p> <p>Results</p> <p>12% (n = 370) of Finnish undergraduate students had used the web-based health advice service and were identified as 'users'. The proportion of male students reporting allergic rhinitis or conjunctivitis was greater among users than non-users (24%, n = 22 vs. 15%, n = 154, χ², P = .03). The proportion of female students reporting chronic mental health problems was greater among users than non-users (12%, n = 34 vs. 8%, n = 140, χ², P = .03). There was no statistical significance between the group differences of male or female users and non-users in self-reported health status (good or fairly good, average, rather poor or poor).</p> <p>Conclusion</p> <p>Among young, highly educated adults the use of a web-based health advice service is not associated with self-reported health status. However, a web-based health advice service could offer support for managing several specific chronic conditions. More research data is needed to evaluate the role of web-based health advice services that supplement traditional forms of health services.</p