HEALTH AND WELL-BEING OF NUI GALWAY UNDERGRADUATE STUDENTS: THE STUDENT LIFESTYLE SURVEY

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1 HEALTH AND WELL-BEING OF NUI GALWAY UNDERGRADUATE STUDENTS: THE STUDENT LIFESTYLE SURVEY PÁDRAIG MACNEELA 1, CINDY DRING 2, ERIC VAN LENTE, CHRISTOPHER PLACE, JOHN DRING AND JOHN MCCAFFREY 1 1 SCHOOL OF PSYCHOLOGY 2 STUDENT SERVICES NATIONAL UNIVERSITY OF IRELAND, GALWAY 1

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3 1. ACKNOWLEDGEMENTS We wish to acknowledge the support and assistance of NUI Galway students and staff in carrying out this study. Matt Doran, Mary O'Riordan and Una McDermott merit special mention of our appreciation. We would also like to acknowledge the assistance and facilities provided by Student Services, Management Information Systems and the School of Psychology. The NUI Galway Student Projects Fund supported the study through a project grant. The research was conducted independently and as the lead authors we take responsibility for the opinions expressed in the report. Our co-authors assisted us in designing the survey and data collection (Christopher Place), analysis of the data set and drafting the findings (Eric Van Lente, John Dring, John McCaffrey). We hope the Student Lifestyle Survey report will provide useful information on the experience of undergraduate students at NUI Galway. The health and well-being of students are important concerns of the University community. The information we provide could help further target the extensive skills, resources and research expertise available on campus. In addition to identifying priorities for supporting health, the survey findings are a baseline for comparison in the future. Dr Pádraig MacNeela, Lecturer, School of Psychology, and Cindy Dring, MA, Health Promotion Officer, Student Services. June

4 2. BACKGROUND 2.1. INTRODUCTION Student physical, mental, and social well-being is centrally important to the university experience. The Strategic Plan for the National University of Ireland, Galway (NUI Galway) is committed to preparing graduates for learning, life and work, in part through a holistic educational experience and support services. The university environment ought to enable personal and social development alongside the educational experience. The Irish Universities Quality Board (IUQB) described student support services as contributing to this process, "by providing professional services which support the holistic development of the person, thereby enabling all students to achieve their full academic and personal potential" (IUQB, 2006, p. 9). Student welfare services are designed to support and encourage students to make choices conducive to positive health and well-being. Lifestyle choices can have a profound impact on students at university and subsequently. Evidence is therefore required to identify priority issues for student support services and the university community more generally. The Student Lifestyle Survey was carried out to assess student health and well-being and as a baseline to measure change over time. The findings can be used to inform policies and strategies aimed at supporting students STUDENT WELL-BEING The transition to third level is a critical period. In the course of attending university, students form friendships, new living arrangements and social patterns. This experience is one of the most positive and memorable stages in life. However, going to college is also a time when adjustment difficulties and harmful health-related behaviours can become established. Thus, university life brings challenges such as managing lifestyle choices, the development of self care skills and personal independence (Parker et al., 2002). Students encounter and must adjust to new demands in social, academic and financial domains. It is, therefore, important to engage with students in relation to their health in order to support successful university experience, linked to both academic performance and student retention (DeBerard et al., 2004; Pascarella et al., 2007) THE STUDENT LIFESTYLE SURVEY The Student Lifestyle Survey (SLS) was carried out to explore the behaviours, perceptions and experiences of a cross-section of NUI Galway undergraduate students. The College Lifestyle and Attitudes National (CLAN) Survey was used as a guide in planning the study (Hope et al., 2005). The CLAN survey was carried out in 2002 with a sample of 3,259 full-time undergraduate students. It established a profile of student lifestyle habits in respect of general and mental health, diet, exercise, accidents and injuries, sexual 3

5 health, substance use and drinking patterns. This was the first survey of health behaviours and attitudes among third level students in all Irish universities and Institutes of Technology. Coping skills, work / study balance, and alcohol-related harm were particular areas of concern identified in the findings. The CLAN survey found that regular binge drinking was associated with a cluster of risky or harmful behaviours, such as cannabis use and cigarette smoking and other negative consequences such as money problems, academic difficulties, fights and unprotected sex (Hope et al., 2005). The definition of binge drinking used in the SLS is the same as that used in the CLAN survey, namely, consuming eight or more standard drinks on one drinking occasion. This equates to four pints of beer, a bottle of wine or seven single measures of spirits (Hope et al., 2005). Drawing on the CLAN survey, the SLS was designed to provide an updated picture of health behaviours and attitudes among NUI Galway students. It also extended the CLAN survey methodology, by including a wider range of mental health questions and a section on student engagement RESEARCH AIM The Student Lifestyle Survey was designed as a cross-sectional survey of NUI Galway students on attitudes, health behaviours and academic engagement, to address the following aims: Provide an overview of lifestyle habits and attitudes among undergraduate students. Make a comparative analysis of responses to different survey topics according to gender and year of study. Provide baseline data on health behaviours, such as drinking patterns, drug use, and smoking to inform initiatives that support student health and well being SUPPORT AND FUNDING Funding to carry out the Student Lifestyle Survey was provided by the Student Project Fund at NUI Galway, following approval of the project proposal. A consultation group was formed to guide survey development, comprising university staff from the Centre for Excellence in Learning and Teaching, college advisory services, Student Services, the Students Union, Counselling Services, and the Health Promotion Research Centre. The study received approval from the University s Research Ethics Committee. 4

6 3. METHODOLOGY 3.1. DESIGN Students responded to a self-administered survey that was hosted on an online survey website. The sampling frame comprised all full-time undergraduate students. Students were randomly sampled from a list provided through university databases, using a stratified sampling procedure to elicit proportional representation from NUI Galway colleges and by year of course. Students were contacted to take part by sending an invitation to their university address. A prize draw was provided as an incentive to complete the questionnaire. A response rate of approximately 30% was anticipated. Given the intention to conduct statistical analysis of sub-groups, a target sample size of 1,202 was calculated. Therefore an invitation was sent to 3,500 students using a sampling frame provided through university information services. The delivery of 37 s failed, and 986 students responded, giving a response rate of 28%. Analysis of responses by item indicated non-completion of some survey items, especially toward the end of the survey. A final sample of 841 students was retained following appraisal of missing data, and is the sample used in presenting the findings SUMMARY OF STUDENT LIFESTYLE SURVEY CONTENT The survey form was divided into seven topics (Appendix 1). Validated measures were included along with items from international, national and college surveys. We drew on the CLAN survey questionnaire for items and reviewed surveys such as SLÁN, HBSC, ESPAD, the Trinity College study on sexual health, the Higher Education Authority European Student Survey and the international ECAS study on drinking patterns. The SLS comprised the following sections: 1. Welcome. Introduction to the purpose of the research, study information and contact details for the researchers. 2. About you. Demographic items adapted from the CLAN survey. 3. General health, food habits and tobacco use. One-item measure of physical health (CLAN); tobacco use indicators from the 2007 SLAN survey (Morgan et al., 2008); items on fruit and vegetable intake based on current HSE healthy eating guidelines; items on sleep adapted from the Sleep Heart Health Study Questionnaire (Quan et al., 1997). 4. Alcohol use. CLAN items on drinking frequency, consumption of specific drinks, frequency of binge drinking (four pints of peer, a bottle of wine, seven single measure of spirits, six premixed spirits), harmful 5

7 consequences of drinking; the RAPS 4 four-item measure of clinically significant alcohol dependence during the last year (Cherpitel, 2000). 5. Other substances. Items on frequency and recency of cannabis use (CLAN); the Severity of Dependence Scale to assess cannabis dependence (Martin et al., 2006); items to assess frequency of use of other drugs (CLAN). 6. Sexual health. Items on sexual activity status, condom use, emergency contraception, based on the American National Longitudinal Study of Adolescent Health (Udry, 2003), the Youth Risk Behavior Surveillance System (CDC, 2009) and CLAN. 7. Mental health. One item mental health measure (CLAN); perceptions of stress measure adapted from CLAN scale (response options from 'very often' to 'never'); the physical vitality and mental health subscales of the SF-36 measure of health and well-being (Ware, 1993). 8. Student engagement. The first section of the Shortened Experiences of Teaching and Learning Questionnaire for higher education (items 1-8; ETL Project, 2005); Supportive Campus items from the US National Survey of Student Engagement Benchmarks of Effective Educational Practice (Kuh, 2001); the Basic Needs Satisfaction measure of selfdetermination (measures of perceived autonomy, competence, and social relatedness; Gagne 2003); evaluation of the educational experience at NUI; overall mark for the previous academic year (or Semester 1 mark for first years); awareness of student support services and university facilities; hours per week spent in volunteering, sports participation, societies and club. 9. Thank you. Information on student support services PROCEDURE The survey content was developed in consultation with the project steering committee. We recruited university staff and student representatives to this group to draw on specialised knowledge of the student experience. This collaborative approach assisted in item design and selection of standardised measures. The SLS was presented online. We designed a survey form hosted on a survey website, and piloted it with 20 students. The final form was completed following feedback on layout, question formulation and overall design. Completion of the survey required approximately 35 minutes. The steering committee approved the final version of the survey. Data collection took place during in spring 2009, avoiding exam periods and holidays. An invitation with introductory information on the survey was sent to randomly selected undergraduate students. A link to the survey webpage was provided in the . A reminder was sent after 10 days and again three weeks following the initial mass . We were permitted to make announcements before class and used posters and flyers to raise awareness of the survey on the campus. 6

8 On clicking the link, the respondent was taken to the survey welcome page, giving information on the SLS and contact information for the researchers. Students were informed that by clicking to go to the next page the survey would begin, and that they could discontinue at any time. The participants were given the option to a named researcher to enter the draw. This method ensured we did not link the person to individual survey responses. The data were downloaded and organised into a data set using the SPSS 18 package for statistical analysis. Descriptive information was reviewed during data cleaning and decisions made about missing entries in the survey, resulting in a final sample of 841 participants. A targeted statistical analysis of the data followed an initial analysis of trends, using descriptive methods and inferential statistical tests. We used the chi-square test, parametric correlations, t-test for independent samples and linear regression inferential tests. 7

9 4. RESULTS 4.1. DEMOGRAPHICS The NUI Galway Student Lifestyle Survey returned a sample of 841 full-time undergraduate students. Table 1 shows the demographic characteristics of the sample, across year of study, College, and accommodation type. The students were mostly female and predominantly aged under 21 (females: 59%, males: 41%). Table 1: Presentation of survey respondent demographics expressed in percentages, by gender Males Females Total No of respondents N=341 N=500 N=841 % % % Gender Age category % aged under 21 years years Year in college 1 st year nd year rd year plus College of study Arts, Social Sciences and Celtic Studies Business, Public Policy and Law Engineering and Informatics Medicine, Nursing and Health Sciences Science Relationship status Married In a relationship Single Accommodation type Lodgings Parents / guardians College residence Rented house Living with partner and/or children Nationality Irish national Non-Irish national LIVING CONDITIONS INCOME, EXPENDITURE, TIME ALLOCATION This section explores the demographic characteristics of the students in more detail, focusing on finances and how students reported using their time. 8

10 Income Family was the predominant source of income, with 75% of the students receiving this support, followed by paid employment (42%). Over one quarter (28%) received a local authority or State grant. Much smaller percentages of students (6-7%) reported income from a fellowship or scholarship, social welfare payments or bank loans. There were variations in the amount typically received in each income category. Although a small proportion received social welfare, the average amount of 620 per person in receipt of this income was larger than the amount typically received from the family ( 382) or employment ( 354). A broadly consistent pattern was reported across year of study, although the proportion of students working reached a peak in Year 2. Male students in employment reported receiving higher income from this source than their female counterparts ( 382 compared with 336). Table 2: Sources of monthly income a and mean income from each source in Euro, by gender Students with Males b Females b Total b this income source (N, %) Family 630 (75%) Employment 357 (42%) Local Authority/State Grants 238 (28%) Fellowships/Scholarships 55 (7%) Social Welfare 51 (6%) Bank Loans 50 (6%) a only for students with this source of income b 5% trimmed mean for just those who have this source of income Expenditure Those students not living at home reported accommodation as their largest single expense. Seventy-two per cent reported expenditure on accommodation, with males and females reporting paying similar amounts ( 343). Some expenditure categories were nearly ubiquitous. Nearly all reported expenditure on food (97%) and phone (92%). Among those who reported a particular expenditure category, an average of 135 was spent on food, compared with 89 for alcohol, 62 for transport, 62 for tobacco, and 51 on regular bills such as electricity. 9

11 Table 3: Mean monthly expenditure a in Euros, by gender Students with Males b Females b Total b this expense (N, %) Food 812 (97%) Phone 777 (92%) Clothing and toiletries 702 (83%) Alcohol 679 (81%) Transport 676 (80%) Entertainment 649 (77%) Accommodation 601 (72%) Study materials 551 (66%) Regular bills (ESB, etc.) 516 (61%) Medical expenses 223 (27%) Tobacco 139 (17%) Grinds 29 (3%) a only for students with this source of expense b 5% trimmed mean for just those who have this expense Time allocation and academic performance The students reported an average of 17.3 hours spent in the classroom during a typical week during the semester (Table 4). This compared with an average of 10.6 hours reported for personal study (i.e., academic activities outside class). Those with part-time jobs reported working 12.7 hours per week on average. Table 4: Mean number of hours allocated per week to academic and paid work, by gender Male Female Total Classes/tutorials Personal study (not exam time) Paid employment (among those working) Table 5 reports on extracurricular activities. Taking part in sports was the most prevalent type reported. Nearly half of the sample reported this activity. When time spent playing sports was averaged, men allocated significantly more time playing sports than women did. One in eight (13.3%) students reported volunteering, compared with 24.4% who considered themselves active in society activities and a similar proportion (25.4%) involved in sports clubs. Taken together, 43.8% were active in one or more form of organised extracurricular involvement (i.e., sports clubs, societies, volunteering). Spread across the entire group, the mean number of hours spent playing sports was 2.5 hours per week, compared with 1.1 hours for sports clubs, 0.9 hours for societies, and 0.4 hours for volunteering. 10

12 Table 5: Mean number of hours allocated per week to extracurricular activities, by gender Male Female Total % Reporting this activity Sports ** 46.4 Sports clubs ** 24.4 University societies Volunteering *Significant between gender (p<.05) **Significant between gender (p<.01) Of the total sample, 767 students reported on academic performance in the past year ("thinking about your previous year, what was your average % mark? For first years, what was your semester one mark?"). Table 6 displays percentages of students in different grade categories, organised by gender. Females reported a slightly higher mark on average, but this difference was not statistically different. Table 6: Percentage of students in each category of academic marks, by gender Males Females Total 49% or less % % % % % GENERAL HEALTH, MENTAL HEALTH, STRESS AND WELL-BEING General Health Students were invited to rate their general health using a one-item measure with five options, from 'poor' to 'excellent' (Figure 1). Overall, 57% perceived their general health to be excellent or very good, a further 34.5% perceived it as good and 8.6% responded with 'fair' or 'poor'. Twice as many men (22%) as women (10%) reported excellent health, a gender difference reflected in responses to other measures of physical vitality reported below. 11

13 Percentage Figure 1: General health by gender General Health (One-Item Measure) Poor Fair Good Very good Excellent Genral Health Males Females Sleep and Nutrition About 22.5% of students got less than seven hours sleep on week nights, with 6% reporting less than six hours per night. More commonly, students described having seven (38.8%) or eight hours (32.6%) sleep per night during the week. There was a tendency to catch up on sleep at the weekend, with 40.7% reporting getting nine hours or more a night. Students reported on the typical number of fruit and vegetables consumed each day. Nearly one-fifth (19.4%) reported consuming less than the recommended five portions or more per day. A slightly larger proportion of students (23.6%) reported consuming five portions only. This represents over 40% of the sample who consumed less than or just about the minimum advised number of portions Mental Health Almost two-thirds of students (65.8%) reported their mental health as "very good" or "excellent" on a one-item, five-point measure ("How would you rate your own mental health?". This is somewhat higher than the percentage who reported comparable levels of physical health (57%). Approximately 11% of the sample rated their mental health as fair or poor (Figure 2). There was a 12

14 Percentage significant gender difference in mental health self-ratings, reflected in the proportions reporting excellent mental health by (males: 31%, females: 19%). Figure 2: Self-rated mental health by gender Mental Health (One-Item Measure) Poor Fair Good Very good Excellent Self-Reported Mental Health Males Females Stress Perceptions The students were asked how often they were stressed, in relation to 12 different sources of stress that had been identified in the CLAN survey of Irish third level institutions (Hope et al., 2005). The 12 items are scored on a fourpoint scale ('never' to 'very often' stressed). Higher scores indicate higher frequency of self-reported stress. Item responses had acceptable internal reliability (Cronbach s α: 0.80, 95% CI = ). Responses can be assessed individually by item or as a total stress score. Males reported a significantly lower total score than females on the stress perceptions measure (mean score of 24.0, SD: 5.9, compared with 25.7, SD: 5.3). The most commonly reported sources of feeling 'often' or 'very often' stressed were exams, subject-specific demands, studies in general, and financial problems. Table 7 illustrates the responses in terms of these more extreme response options on the four-point scale. 13

15 Table 7: Percentage reporting feeling 'often' or 'very often' stressed, by item and gender. Males Females Total College Studies Exams ** Subject-specific demands ** Studies in general ** Living Conditions Financial situation ** Family situation * Living situation Personal & Interpersonal Relationships Competition at college ** Anonymity at college Circle of friends * Illness Sexuality * χ 2, significant between gender (p<.05) ** χ 2, significant between gender (p<.01) Mean scores for the stress items ranged from 3.0 (SD: 0.8) out of 4.0, for the item on exams, to 1.3 for the item on sexuality as a stressor (SD: 0.6). The items related to university courses were reported as the most common sources of stress, followed by living conditions, and personal or interpersonal stressors. Gender differences in mean scores were particularly strong in respect of college studies, finances and competition at college Physical and Mental Well-Being Two multi-item measures of health and well-being are reported on here. These are sub-scales of the SF-36 assessment tool. The SF-36 is used extensively internationally and across population groups. The two scales are the energy and vitality index (EVI) (Cronbach s α: 0.82, 95% CI = ) and the mental health index (MHI-5) (Cronbach s α: 0.84, 95% CI = ). Table 8 describes the SF-36 items individually, highlighting scores on the sixpoint scale by gender. Mean scores have been reversed where appropriate (e.g., 'worn out') so that in all cases, higher scores indicate positive responses. Females reported lower scores on physical well-being items for energy and tiredness. Significant differences were noted on three of the five mental health well-being items. Males reported higher levels of mood (i.e., less 'down') and a greater sense of calm. Scores on individual items can be converted into a score for each scale, with significant gender differences noted in total scores as well as well as in individual item scores. 14

16 Table 8: SF-36 energy and vitality and mental health scores by gender Males Females Total Energy and Vitality (EVI) Full of life 4.1 (1.2) 3.9 (1.1) 4.0 (1.1) Energy 3.9 (1.2) 3.6 (1.2) 3.7 (1.2)** Worn out a 4.1 (1.3) 3.9 (1.2) 4.0 (1.2)* Tired a 3.7 (1.2) 3.3 (1.2) 3.5 (1.2)** Mental Health (MHI-5) Nervous a 4.5 (1.3) 4.4 (1.3) 4.5 (1.3) Down in the dumps a 5.1 (1.2) 4.8 (1.2) 4.9 (1.2)** Calm and peaceful 3.9 (1.1) 3.6 (1.1) 3.7 (1.1)** Downhearted and blue a 4.6 (1.2) 4.4 (1.1) 4.5 (1.8)** Happy 4.4 (1.1) 4.3 (1.1) 4.3 (1.1) Total Scale Scores EVI Score (0-100) 59.3 (19.3) 53.6 (19.1) 55.9 (19.4)** MHI-5 Score (0-100) 70.1 (18.7) 65.7 (18.0) 67.5 (18.4)** *Significant between gender (p<.004) **Significant between gender (p<.001) a Item cores reversed, higher numbers indicate more positive scores for all items In common with the findings of the SLÁN study of a representative sample of Irish adults, male students had higher scores than female students on both SF-36 scales. However, reported energy / vitality and mental health were relatively low compared with the recent SLÁN population survey and international studies (e.g., Morgan et al., 2008) (Table 9). Mean scores by male students on the physical vitality scale lagged 13 points below the population average in the SLÁN survey on the scale, and 12 points lower on the mental health scale. Female survey respondents were 15 points below the female population norm on the physical vitality scale, and 15 points lower on the mental health scale. Table 9: Mean SF-36 scores on the energy and vitality / mental health scales for SLS and SLÁN national surveys, by gender Males Females Total SLS Energy and Vitality (EVI) 59.3 (19) 53.6 (19) 55.9 (19)** Mental Health (MHI-5) 70.1 (19) 65.7 (18) 67.5 (18)** SLAN national survey Energy and Vitality (EVI) 72.6 (19) 68.3 (19) 71.0 (19)** Mental Health (MHI-5) 82.0 (16) 80.3 (16) 82.0 (16)** *Significant between gender (p<.005) **Significant between gender (p<.001) Relatively low SF-36 scores have been noted in previous research with UK student populations (Stewart-Brown et al., 2000). The 1,200 students surveyed in Stewart-Brown et al.'s study of three UK higher education institutions reported relatively low scores on the vitality and mental health SF- 36 sub-scales. The mean vitality score for these students was 53.0, compared with the UK national population norm for year olds of The equivalent mean mental health sub-scale score for UK students was 65.6, 15

17 compared with the year old norm of Female students reported lower scores, similar to the pattern identified in the responses to the SLS. HIGHLIGHT: NUI Galway Students With a Disability This study was carried out in 2012 by David Murray for a Higher Diploma in Psychology research dissertation, in collaboration with the NUIG Disability Support Service (DSS). Seventy-six students registered with the DSS were surveyed for the study. The survey included the items on perceived stressors and student engagement reported on in the SLS. This approach illustrates the utility of using a similar set of indicators among particular sub-groups of the student population in order to make comparisons with the rest of the university community. Students with a disability were more likely to report feeling often or very often stressed by particular stressors, compared with the SLS group. (73% by their studies in general, SLS: 60.3%; 85% by subject-specific demands, SLS: 60.4%; 47% by competition at college, SLS 22.4%; 79% by exams SLS: 73%; and 38% by illness, SLS: 11.4%). Students with a disability were more likely to report that NUI Galway emphasises spending time on academic work quite a bit or very much (79%, SLS: 71.7%) Students with a disability were less likely to report that NUI Galway emphasises the support to succeed academically quite a bit or very much (52.5%, SLS: 62.5%) Students with a disability were more likely to report that NUI Galway emphasises helping students to cope with nonacademic responsibilities quite a bit or very much (36.6%, SLS: 34.4%) Students with a disability were less likely to report an emphasis by NUI Galway on social thriving (39.4%, SLS: 51.5%) Students with a disability were less likely to report that NUI Galway emphasises attending academic events and activities (41.4%, SLS: 61.2%) This survey also asked about perceptions of the disability support. A high level of satisfaction with disability support services (including assistive technology services) was reported. However, the items on stressors and student engagement indicate that NUI Galway students with a disability may perceive more challenges to having a successful university experience, compared with others. 16

18 4.6. SEXUAL HEALTH Almost six out of ten of all students (59%) reported being sexually active in the last month (males: 64%; females: 55%). When asked whether a condom had been used on the last occasion of having sex, 68% said yes, 20% said no, and the remaining 12% chose the not applicable option. The most common reasons reported for not using condoms were being in a monogamous relationship (13.8% of the sample), impaired judgement due to alcohol or drugs (7.9%), and loss of sensation (6.9%, with more males reporting this item, 12.1% males to 3.4% females). A quarter of students or their partners had used emergency contraception at least once. There was a significant difference in reporting by gender (males: 16%, females: 32%), implying that many males were unaware of their sexual partners' use of emergency contraception SUBSTANCE USE TOBACCO AND DRUGS One of the aims of the Student Lifestyle Survey was to assess how students were using alcohol, tobacco, and drugs such as cannabis, Ecstasy and cocaine. Particular attention is paid to depicting alcohol consumption patterns, following the description of self-reported use of tobacco and illicit drugs Tobacco Nearly one in four students (23%) reported being current smokers, with males significantly more likely to report this status (males: 25%; females: 21%, p =.04). Students classified as current smokers were those who reported smoking 'regularly' or 'occasionally (usually less than once a day)'. Some 65% of students had smoked at least 100 cigarettes in their lives, with significantly more females reporting this (males: 60%; females: 69%) Illegal Drugs - Cannabis Cannabis was by far the most common illegal drug reported by students. Fifty per-cent indicated they had taken cannabis at least once in their life (females: 47%; males: 56%). Almost a fifth (18%) had taken the drug more than 20 times, with a significant gender difference (males: 25%, females: 12%). Onethird of participants (34%) reported taking cannabis at least once in the past twelve months. There was a gender difference in reported cannabis use in the past year, with 41.3% of males and 29.2% of females indicating they had taken the drug (see Table 10 below). Of those who reported using cannabis in the past year, 60.4% used it three or more times, making it the illegal drug with the most frequent overall usage. Fourteen per-cent of the sample reported taking the drug in the past 30 days, while 5% of males and 2% of females using it ten or more times in the past 30 days. Some 24% (n=207) of students responded to all five questions on the Severity of Dependence Scale used to assess cannabis use (Cronbach s α:.84, 95% CI = ; Martin et al., 2006). About 7% of these students (males: 10%, females 4%) were above the cut-off score of 3 that is indicative 17

19 of dependence. For the purposes of the analysis, we identified relatively frequent cannabis users as students who reported its use six times or more in the past 12 months and who completed the cannabis dependence scale. Considering these students only, 14% sometimes or often thought their cannabis use out of control, 3% indicated it to be 'quite difficult' or 'impossible' to stop using the drug, 5% reported feeling anxious or nervous at the prospect of missing a smoke, and 7.6% reported wishing they could stop. No significant gender differences were noted on responses to the cannabis dependence scale Illegal Drugs Besides Cannabis Students were asked about use of other illegal drugs in the last 12 months. Ecstasy was the second most commonly used drug after cannabis, albeit with a much lower prevalence (ecstasy: 9%; cannabis: 34%). The next most common drugs reported were cocaine (7%), salvia (6%) and magic mushrooms (5%) (Table 10). Table 10: Illegal drug use in past 12 months, by gender and frequency of use Males Females Total % users taking drug 3+ times in past year Cannabis ** 60.4 Ecstasy (E, XTC) ** 47.2 Cocaine (Coke, Crack) Salvia, BZP ** 32.7 Magic Mushrooms (Mushies, peyote) ** 12.8 Amphetamine (Speed, Whizz, uppers) LSD (Acid, Trips) * 15.8 Tranquillisers/sedatives Stimulants (Ritalin) without prescription Solvents (Gas, Glue) Heroin (Smack, Skag) a vs. once or twice among users of the drug *Significant between gender (p<.05) **Significant between gender (p<.01) With the exception of cannabis, the frequency of drug use was usually reported as once or twice in the past twelve months. By comparison, 60% of cannabis users reported using it three or more times. Ecstasy was next most frequently used drug, with nearly half of users (47%) in the past year reporting using it three times or more. There were some gender differences besides those already reported on cannabis use. Males were also more likely to report using Ecstasy, Salvia / BZP, magic mushrooms, and LSD, although the prevalence of use of these drugs was relatively low. 18

20 4.8. ALCOHOL Drinking Habits: Frequency, Quantity and Beverage Type About 73% of students had consumed alcohol during the last week and 91% in the last month. Some 6% were non-, reporting that they never had alcohol beyond sips and tastes (5%) or did not have a drink in the last twelve months (<1%). Although non-irish nationals were a relatively small proportion of the participant group (5.6%), they represented 28% of the nondrinker group. An average of 14 standard drinks were consumed per week, with males reporting an average of 17 standard drinks and females an average of 12 standard drinks. One-third of men reported drinking more than the recommended limit of 21 standard drinks per week, compared with 39% of women drinking more than their recommended limit of 14 standard drinks. The students were asked about their consumption of several types of drink, allowing us to estimate the breakdown of drinking by beverage. The average of 17 standard drinks consumed by males works out to 11 standard drinks in beer / cider, one glass of wine, and five measures of spirits. The equivalent figures for females are three standard drinks in beer / cider, three glasses of wine, and six measures of spirits. Thus, spirits represent half of the alcohol use reported by women compared with less than a third of the alcohol reported by men. Students were asked how often during the last 12 months they consumed (a) beer/cider, (b) wine, and (c) spirits, from every day to never. Less than 4% drank any specific drink 4-5 days a week or more. Beer/cider consumption once a week was reported by 51%, compared with 25% for drinking wine, and 51% for spirits. Men were nearly twice as likely to drink beer as women (males: 69.4%; females: 35.5%) at least once a week. This was a significant difference, complemented by the greater likelihood of females reporting drinking wine at least once a week (males: 18.8%; females: 29.1%). There was no gender difference in likelihood of drinking spirits at least once a week (males: 46.8%; females: 53.8%). Binge drinking is defined in this report as drinking at least 75 grams of pure alcohol on a given occasion (i.e., at least four pints of beer or equivalent). Just under fifty per-cent (49.9%) were categorised as high frequency or regular binge, defined here as reporting binge drinking once a week or more (Table 11). 19

21 Percentage Table 11: Binge drinking frequency, by percentage and gender Males Females Total Four times per week or more Two-three times per week Once a week Once a month to once a week Once or twice a year Never / don't know a ai Includes non- Taking just those students who drink, more than half (53%) reported binge drinking at least once a week (Figure 3). Men (66%) were significantly more likely than women (44%) to report regular binge drinking at this frequency. Figure 3: Frequency of binge drinking by gender in the last 12 months, among those who reported drinking alcohol. Binge Drinking Frequency Never / Rarely 1 Month 2-3 Month 1 Week 2-3 Week 4+ Week Frequency of Binge Drinking Males Females Alcohol-Related Problems and Harms Responses to the four-item RAPS scale (Rapid Alcohol Problems Screen) showed that 52% of reported having felt guilt or remorse after drinking, 28% failed to do things because of drinking, 60% had experienced not remembering things they said or did, and 3% reported having a drink in the morning (Table 12). Responding positively to any one of these items is an indicator of an alcohol problem. Although men reported drinking more than women, gender differences in responses to RAPS items were not marked. 20

22 Table 12: Percentage reporting experience of alcohol problems, by gender Males Females Total Guilt or remorse after drinking Not remember things you said or did Failed to do things because of drinking Drink in the morning ** Total RAPS score (mean/sd) 1.5 (1.1) 1.4 (1.1) 1.4 (1.1) *Significant between gender (p<.05) **Significant between gender (p<.01) The RAPS scale represents harmful outcomes of drinking in the form of 'alcohol problems'. The survey also included a further list of harms and risks. These refer to harmful consequences or exposure to risk, as a result of their own drinking or that of others (Table 13). Over four-fifths (84%) of students who drank alcohol reported at least one of these (males: 88%; females: 82%). There was a particularly high prevalence of regret after drinking (59%), missing school / work days (54%), and feeling the effects while at work / college (50%). There were gender differences such as males being more than twice as likely to report having gotten into a fight. As with most of the findings, there were relatively few differences across year in college. Table 13: Percentage reporting experiencing harms or risks due to one s own drinking, by gender Males Females Total Academic performance Felt effects of alcohol while at class/work Missed class/work days ** Harmed studies/work Acute harms Regretted things said or done Got into fight ** Been in accident Personal harms Money problems Unintentional sex Unprotected sex Chronic harms Feel should cut down Harmed health * Social harms Harmed friendships ** Harmed relationship / home-life Mean number of harms (SD) 4.0 (3.0) 3.4 (2.8) 3.6 (2.9)** *Significant between gender (p<.05) **Significant between gender (p<.01) The survey also included a set of items on harms and risks experienced as a result of other people's drinking. Two-thirds of students who drank reported experiencing at least one harm or risk because of someone else's drinking 21

23 (Table 14). The harm cited most often by both genders was verbal abuse (males: 38%; females: 32%). Males were more likely to experience acute and personal harms, whereas females reported arguments and relationship problems more often. Table 14: Percentage reporting experience of risks or harms due to other's drinking, by gender Males Females Total Acute harm Was in a motor car accident Was passenger with drunk driver ** Been hit or assaulted ** Been sexually assaulted Personal Harm Had financial trouble Been verbally abused * Had property vandalised ** Social Harm Had family/relationship difficulties * Had arguments with family/friends * about drinking Mean number of harms (SD) 1.4 (1.4) 1.1 (1.3) 1.2 (1.4)** *Significant between gender (p<.05) **Significant between gender (p<.01) 4.9. STUDENT ENGAGEMENT Self-determination of NUI Galway Students Self-determination corresponds to the personal growth that might be expected to arise as a part of the university experience. The Basic Needs Satisfaction scale was used to assess the self-determination of students (Gagne, 2003). Higher self-determination scores are indicative of positive well-being. For instance, scores are negatively correlated with anxiety, worrisome thinking, generalised anxiety, and feelings of social inadequacy (Johnston & Finney, 2010). The scale includes three factors (Table 15): Personal autonomy: Items that refer to freedom and inner direction. Competence: Items on mastery, control over behaviour and task performance. Relatedness: Need for affiliation with other people. High scores on the three factors assessed in the self-determination measure indicate that psychological needs are perceived as being met. The university experience should ideally contribute to all three factors, through growth of knowledge and job skills, confidence in the ability to achieve valued goals, and feeling connected to other people. Each factor showed good levels of internal reliability. The total scale alpha was 0.88 (95% CI = ), with the alpha on each of the three factors ranging from autonomy (0.70, 95% CI = ) to competence (alpha: 0.71, 95% CI = ), and 22

24 relatedness (0.84, 95% CI = ). Each factor had different number of items. Examination of mean item scores showed that satisfaction of the relatedness need was highest (eight items, mean score: 5.6 on seven-point scale). The mean item score for autonomy was next (seven items, mean item score 4.9 out of 7.0), followed by mean scores on competence items (six items, 4.5 out of 7.0). There were no gender differences in responses to the self-determination measure. The scores recorded are slightly lower than those found in two recent surveys of approximately 4,000 students at a US university (Johnston & Finney, 2010). Autonomy scores for NUI Galway students were marginally lower (mean score of 34.8) than those reported in the two student surveys Johnston and Finney conducted (mean scores: 35.6, 35.8). Competence scores were lower in the NUI Galway sample (mean score: 27.5; US survey groups: 32.0, 31.0), as were relatedness scores (NUI Galway: 44.6; US survey groups: 48.0, 47.5). Table 15: Mean score for each self-determination factor, by gender Male Female Total Autonomy 34.9 (6.3) 34.8 (6.4) 34.8 (6.4) Competence 27.3 (5.7) 27.7 (6.1) 27.5 (5.9) Relatedness 44.5 (7.7) 44.7 (7.5) 44.6 (7.8) Total score (16.9) (17.0) (16.9) Expectations of Higher Education at NUI Galway Students were asked about their motives and expectations for the university experience as NUI Galway. This occurred using items taken from the Shortened Experiences of Teaching and Learning Questionnaire. The items were scored on a five-point scale ('very weakly/not at all' to 'very strongly'). Some 88% of students indicated they were 'fairly' or 'very strongly' motivated to develop personally through the experience (Table 16). Nearly half (48%) reported similar expectations for their sports and social life, and 11.2% fairly or very strongly wondered why they ever came here. Women reported higher levels of engagement in personal development, reflected in items on making a difference in the world and becoming independent. 23

25 Table 16: Percentage reporting 'fairly' or 'very strongly' to student engagement items, by engagement factor and gender Male Female Total Focused on sports and social life Hope to develop independence and confidence ** Need qualification for good job Wonder why I ever came here Intrinsic engagement sub-scale Hope to develop personally Want to make a difference in the world ** Want to study subject in depth a Other three categories are very weakly/not at all Rather weakly and Somewhat/not sure *Significant between gender (p<.05) **Significant between gender (p<.01) Overall Experience at NUI Galway and Perceived Institutional Emphasis The NUI Galway student experience was assessed using one of the sections validated in the US National Survey of Student Engagement (Kuh, 2001). The section on the supportiveness of the campus environment comprises five items scored on a four-point scale (Cronbach s alpha:.73, 95% CI = ). Students were asked about the extent to which NUI Galway emphasizes particular issues relevant to the student experience. Some 72% of students reported that NUI Galway emphasizes academic work to students 'quite a bit' or 'very much' (Table 17). Only 34% of students felt that the university emphasized coping with non-academic responsibilities to the same extent. There were some minor gender differences in ratings. More women rated academic and on-campus participation as being emphasised quite a bit or very much in the university. A single item was used to asses the quality of the overall experience at NUI Galway. Almost 30% students described their academic experience as excellent. Most found it to be good, while 16% reported it as fair or poor (excellent: 29%; good: 55%; fair: 14%; poor: 2%). Table 17: Percentage reporting 'quite a bit' or 'very much' in response to items about 'what NUI Galway emphasises'' Male Female Total Spending time on academic work * Providing support for academic success Helping cope with non-academic responsibilities Supporting social thriving Attending campus events and activities * a Other categories are: Some and Very little. *Significant between gender (p<.05) Awareness and Use of Student Services Students were asked about their awareness and use of services (Table 18). The Sports Centre had the highest usage, with more than half reporting using it. Awareness of over 90% was reported for the Health Centre, with the Health Promotion, Chaplaincy, Counselling and Careers advisory services also 24

26 achieving very high awareness. Gender differences in service awareness and usage were noted, with males more likely to use the Sports Centre and Disability service. Women were more likely to report using the Health Centre and Counselling Service. Table 18: Percentage reporting awareness and use of student facilities and services, by gender Awareness / Use Males Females Total Sports centre Not aware of it ** Know of it, but haven't used it ** Already used it ** Health centre Not aware of it ** Know of it, but haven't used it ** Already used it ** Health promotion Not aware of it Know of it, but haven't used it Already used it Chaplaincy Not aware of it Know of it, but haven't used it Already used it Disability support Not aware of it * Know of it, but haven't used it * Already used it * Counselling Not aware of it ** Know of it, but haven't used it ** Already used it ** Careers advisory Not aware of it Know of it, but haven't used it Already used it *Significant between gender (p<.05) **Significant between gender (p<.01) 25

27 HIGHLIGHT: NUI Galway Students Who Volunteer This research was carried out in 2012 by Marese O'Brien for a MSc in Health Psychology research dissertation, and used several of the same measures included in the Student Lifestyle Survey. Two surveys were carried out. One was a follow-up survey with persistent volunteers, comprising 80 students who had been volunteering in November 2010 and were still doing so in Spring These students were now in 2nd / 3rd year or in postgraduate study. The second survey was a cross-sectional survey of students engaged in volunteering, both on- and off-campus. The demographic profile of this latter group of 230 volunteers was more directly comparable to the SLS respondents, with one-quarter in first year at college. The surveys of volunteers indicated some important differences with the SLS findings for the general undergraduate population. Volunteers were more likely to report very good or excellent general health (69% of persistent volunteers, 71.6% of the larger cross-section, and 57% of SLS respondents) Volunteers were less likely to have had a drink in the past week (persistent volunteers 60.3%, compared with 68.4% of the larger volunteer group, and 73% of the SLS respondents) Volunteers reported lower levels of binge drinking (20.6% of persistent volunteers reported binge drinking once a week or more, 38.5% once a month to once a week; 35.2% of the larger group of volunteers reported binge drinking once a week or more, 31.8% once a month to once a week; compared with the equivalent SLS figures of 50% for binge drinking once a week or more, 27.7% once a month to once a week) Volunteers reported fewer alcohol-related harms (44.6% of persistent volunteers, 49.2% of larger volunteer group, and 58.8% of SLS group reported experiencing regret following drinking; 20.3% of persistent volunteers, 36% of larger volunteer group, and 40.6% of SLS respondents reported that drinking had harmed their work or studies; 14.9% of persistent volunteers, 33.1% of larger volunteer group, and 30% of SLS respondents reported that alcohol had harmed their health; 28.4% of persistent volunteers, 39.8% of larger volunteer group, and 49.8% of SLS respondents reported having felt the effects of alcohol while at work or in class) 26