title: College health service capacity to support youth with chronic medical conditions.
abstract: OBJECTIVE
  Twenty percent of US youth have a chronic medical condition and many attend college. Guidelines for transition from pediatric to adult care do not address college health services, and little is known about their capacity to identify, support, and provide care for these youth. The objective of this study was to describe college health center policies, practices, and resources for youth with chronic medical conditions (YCMC).
  
  
  METHODS
  Survey of medical directors from health centers of a representative sample of 200 4-year US colleges with ≥ 400 enrolled undergraduate students. Patterns of identification, management, and support for youth with a general chronic medical condition and with asthma, diabetes, and depression, were investigated; χ(2) and Fisher exact tests were used to ascertain differences by institutional demographics.
  
  
  RESULTS
  Directors at 153 institutions completed the survey (76.5% response rate). Overall, 42% of schools had no system to identify YCMC. However, almost a third (31%) did identify and add to a registry of incoming YCMC on review of medical history, more likely in private (P < .001) and small (<5000 students, P = .002) colleges; 24% of health centers contacted YCMC to check-in/make initial appointments. Most institutions could manage asthma and depression (83% and 69%, respectively); 51% could manage diabetes on campus.
  
  
  CONCLUSIONS
  Relatively few US colleges have health systems to identify and contact YCMC, although many centers have capacity to provide primary care and management of some conditions. Guidelines for transition should address policy and practices for pediatricians and colleges to enhance comanagement of affected youth.
authors.affiliation: Division of Adolescent/Young Adult Medicine, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and dlemly@partners.org.
authors.forename: Diana C
authors.initials: DC
authors.lastname: Lemly
authors.affiliation: Division of Adolescent/Young Adult Medicine, and.
authors.forename: Katherine
authors.initials: K
authors.lastname: Lawlor
authors.affiliation: Division of Adolescent/Young Adult Medicine, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Scherer
authors.affiliation: Department of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts;
authors.forename: Skyler
authors.initials: S
authors.lastname: Kelemen
authors.affiliation: Division of Adolescent/Young Adult Medicine, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and Department of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts;
authors.forename: Elissa R
authors.initials: ER
authors.lastname: Weitzman
mesh_terms: D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy*; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D013333:Student Health Services / Q000592:standards* / Q000639:trends; D013334:Students; D060305:Transition to Adult Care / Q000592:standards* / Q000639:trends; D014495:Universities / Q000592:standards / Q000639:trends
keywords: chronic medical conditions/special health care needs; college/university health; health care transition; young adults