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College represents a unique time in many Americans life and health. Traditionally, college students are emerging adults — no longer adolescents yet far from responsible adults. It is a critical developmental period that involves change and exploration. Key tasks in the transition to adulthood need to be accomplished, including taking responsibility for one’s own health. While many might assume that emerging adults are among the healthiest segments of the American population, they demonstrate a pattern of unhealthy behaviors related to diet, physical activity, sexual activity, tobacco, and alcohol. These health behaviors can have significant consequences for future health, including early development of chronic disease. AJHE has a focus on publishing research articles, feature articles, and commentary manuscripts that focus on chronic disease and related lifestyle behaviors across the lifespan. AJHE also emphasizes the need for Health Education to be grounded in Health Behavior Theory. As you peruse the manuscripts in this Special Issue, you will find papers on several chronic diseases and lifestyle behavior topics. These papers reveal the importance of health education and health promotion programs on college campuses and demonstrate the potential of health education and promotion in higher education to enhance health and improve learning outcomes.

College life is an exciting time for thousands of emerging adults on campuses across the nation. It is also an opportunity for students to engage in behaviors that can impede personal health. Numerous studies link personal health and wellness to academic achievement. The core mission of most institutions of higher education (IHEs) is academic success. Health promotion supports this mission by creating healthy learning environments. Due to structural and financial constraints operating at different levels within university systems, health promotion efforts typically focus on quantity and less on quality. As IHEs come under increased scrutiny in terms of student retention and operating within shrinking budgets, outcome-based funding may soon direct health promotion programming. This leads to the critical need for health promotion on campuses to understand best practices. To aid IHEs, several initiatives have been launched by the American College Health Association (ACHA).

High-risk drinking (HRD) is a public health priority on college campuses in order to decrease harm to Individuals who engage in HRD, as well as others in their presence. We posit an underexplored impact of campus HRD culture: the exposure of marginalized students to instances of bias perpetrated by those under the influence. Therefore, our focus on the reduction of HRD is not just about the health of drinkers but is also about the dynamics of interpersonal factors and community-level factors that can be upstream determinants of chronic stress and illness, particularly for marginalized college students. We argue that more attention should be paid to the intersection of HRD and intersections with social justice violations. Furthermore, we propose a model based on existing research that connects HRD with incidents of bias that increase stress, thereby negatively impacting well-being and increasing risk for chronic mental and physical illness. We ask our colleagues to incorporate these effects into their data collection, programming, prevention and treatment priorities, and allocation of efforts. Adding a social justice lens to HRD prevention and treatment on campuses expands our ability to ensure that all members of our diverse, inclusive communities thrive while on campus and throughout their lives.

Collegiate recovery programs (CRPs) are emerging as a strategy to provide aftercare support to students in recovery from substance use disorders (SUDs) at institutions of higher education. CRPs are an innovative strategy for Health Educators to support the personal, academic, and professional goals of students in recovery.
Purpose: This article reviews the history and current standards of CRPs as well as provides a case study on the development of a CRP at the University of North Carolina at Greensboro (UNCG).
Translation to Health Education Practice: The early outcomes of CRPs are promising, and the case study presented in this article provides Certified Health Education Specialists with a model to guide the creation of additional CRPs.

The United States Department of Agriculture (USDA) currently recommends that young adults consume 2.5–3 cups of vegetables daily, while also providing weekly recommendations for 5 vegetable subgroups: dark green, red and orange, beans and peas, starchy, and other.
Purpose: The purpose of this study was to explore theory-based determinants of consumption for 5 USDA vegetable subgroups among college students.
Methods: Operationalizing the integrative model of behavioral prediction (IMB), a survey was developed and distributed online to college students (n = 386). Linear regression models were used to predict behavioral intentions of each subgroup with attitudes, perceived norms, and perceived behavioral control (PBC), and logistic regression models predicted whether students met (or did not meet) recommendations, with intentions and PBC.
Results: Collectively, IBM constructs accounted for 40.5%–54.6% of the variance of intentions and 14.2%–44.3% of the variance of each subgroup.
Discussion: Research exploring determinants of vegetable subgroups is rarely done. This study demonstrated that young adults hold different beliefs about subgroups, and theory-based determinants of subgroups vary.
Translation to Health Education Practice: Vegetable consumption is associated with many health benefits, and understanding significant theory-based determinants of each subgroup can help future practitioners develop targeted and tailored programs that promote vegetable quantity and variety.

The prevalence of food insecurity among college students ranges from 14% to 59%. Most of the research to date has examined the determinants of food insecurity.
Purpose: The purpose of this study was to examine the relationships between food insecurity and self-rated health and obesity among college students living off campus.
Methods: An online survey was sent to students 19 years of age or older. Food security status was measured using the Adult Food Security Survey Module. Health status, height, and weight were self-reported. Two logistic regression analyses assessed the associations between food insecurity and the 2 dependent variables, health status and overweight/obesity.
Results: A sample of 351 students provided valid responses to the questions used in these analyses. Food insecurity was not associated with obesity. Food insecure students had significantly higher rates of fair/poor health when compared to their food secure counterparts (odds ratio [OR] = 2.1, 95% confidence interval [CI], 1.1, 4.3).
Discussion: Food insecurity is related to self-rated fair/poor health but not overweight/obesity in college students living off campus.
Translation to Health Education Practice: Health Educators on college campuses should be cognizant of financial conditions that may place students at risk for food insecurity.

Breast cancer, the second leading cause of cancer death among US women, causes severe physiological problems, including treatment outcomes of surgery, radiation, and chemotherapy. It results in severe psychological suffering, including anxiety, depression, and disfigurement. One out of every 8 American women will develop breast cancer at some point in her life. Young women with breast cancer tend to experience more aggressive forms of the disease and with more severe outcomes than older women who develop breast cancer. Early detection and treatment are recommended for reducing mortality and suffering; however, screening behaviors are often avoided.
Purpose: The purpose of this study was to examine breast cancer knowledge, beliefs, and screening behaviors among college women utilizing the health belief model.
Methods: Participants completed a valid and reliable 84-item questionnaire That measured breast cancer knowledge, health motivation, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and breast self-examination practices among a sample of college women in the southeastern United States.
Results: Participants (n = 342) had low levels of breast cancer perceived susceptibility and breast self-examination. Breast cancer knowledge was significantly correlated with breast self-exam. In a regression model, positive self-efficacy and low perceive barriers were associated with breast self-examination.
Implications: Health education program planners can enhance intervention effectiveness by utilizing health behavior constructs focused on increasing perceived susceptibility, enhancing self-efficacy for breast cancer screening, and reducing barriers. Education-based programs are also needed to increase women’s overall knowledge and awareness of breast cancer.

College students actively seek online health information and use Instagram, an image- and video-based social networking website, to build social networks grounded in trust and behavioral norms (social capital), which have the potential to prevent chronic disease.
Purpose: This study aimed to (1) examine how intensity of Instagram use moderates the relationship between eHealth Literacy and online social capital in college students and (2) discuss how Instagram can be used as a social awareness platform for chronic disease prevention among college students.
Methods: Hierarchical regression analyses were conducted to analyze web based survey data from a random sample of college students (N = 327).
Results: Online bridging social capital was associated with greater ehealth literacy (P < .05) and intensity of Instagram use (P < .001), when controlling for sociodemographic variables. The relationship between ehealth literacy and online bridging social capital was strongest among respondents with average-intensity (P < .01) and high-intensity (P < .01) Instagram use compared to low Instagram intensity.
Discussion: High intensity of Instagram use may strengthen college students’ low ehealth literacy, especially when interacting with heterogeneous connections with weaker ties.
Translation to Health Education Practice: Health Education Specialists should continue to explore how college students’ intensity of Instagram use can be strengthened to build bridging online social capital and ultimately prevent chronic disease.