Barriers to Health Engagement for Emerging Adults in Postsecondary Institutions of Durham, North Carolina

The goal of this research project was to identify trends of and barriers to health engagement for emerging adults in postsecondary institutions. The motivation for studying health engagement—which includes all actions taken for, or behaviors relating to, the promotion of an individual’s health—stems from the growing prevalence and financial burden of chronic illness in the United States. Health engagement can help combat chronic illness by promoting more positive health outcomes. Emerging adults represent one target population for this health intervention since they are still forming their identities and lifelong habits. Postsecondary education is pursued by half of emerging adults in the U.S., so these institutions provide a natural avenue for research. This mixed-methods study focused on three postsecondary institutions which included a two-year community college, a public Historically Black University, and a four-year private institution. Statistical analyses on 874 survey responses found that engagement is a significant (p<0.001) predictor of self-reported health status and found significant differences (p<0.01) in the engagement scores and health outcomes among institutions. A regression model on the Youth Engagement with Health Services score identified significant predictors of engagement (R2=0.15; p<0.001). Focus groups, which included a total of 30 participants, helped inform the barriers faced by students and helped explain the significance of the variables in the model. Finally, an engagement process emerged that provides a foundation for institutional policy change to address these barriers.