*Corresponding author: Gay James, Associate Professor, HPERD Department, Jowers Center #172, Southwest Texas State University, San Marcos, Texas, 78666. Phone: 512-245-2942. Fax: 512-245-8678. E-mail: gj04@swt.edu.

Kim Siegenthaler, Associate Professor, Department of Health, Leisure and Exercise Science, Appalachian State University, Boone, North Carolina, 28608.

Michal Anne Lord, Associate Professor, HPERD Department, Southwest Texas State University, San Marcos, Texas, 78666.

The purpose of this study was to examine the health risk behaviors of recreation majors at two four-year universities. The health risks were assessed using the 1995 National College Health Risk Behavior Survey, which had been utilized to monitor health risk behaviors of undergraduate university students across the nation. The study sample was 268 (Texas N=143, North Carolina N=125) undergraduate recreation majors enrolled in entry level and upper level classes.

The results on dietary habits and physical activity varied between the states and from the national results. However, the results of this study indicated that the recreation majors had a higher participation rate than the 1995 national respondents in several high risk activities, such as intentional injuries (accidents), alcohol use, marijuana use, tobacco use, and sexual behaviors. These health behaviors are of concern for two reasons; the risk behaviors are associated with major causes of mortality and morbidity, and the professional concerns for recreation majors and their development of leisure activities. Study results could be utilized in two ways: 1) as a baseline of descriptive data for recreation majors, and 2) in program development to focus on healthy college communities and the reduction of negative behavioral risks for college students, especially recreation majors.

Americans spend approximately 5 to 25% of their annual household income on recreation and leisure activities (Carver, 1997). Recreation opportunities have long been considered an important factor in determining livability of a community. The "Benefits Are Endless" campaign of the National Recreation and Park Association (NRPA) proclaims many ways that recreation contributes to the physical, emotional, intellectual and social well-being of individuals and to the enhancement of the community. Recreation providers, particularly those in the public and not-for-profit sectors, are under greater pressure to demonstrate how their services fulfill their promises to enhance quality of life.

A societal trend indicates that Americans are becoming more concerned with personal and community health. To move in the direction of greater individual and community well-being, Americans must learn to choose healthier recreation and leisure activities (NRPA, 2000b; NRPA, 2000c). Recreation providers must do more than verbalize the ideals of recreation, they must set the example through programs and services. Leisure professionals must understand the interaction between leisure lifestyle and health. If they are to be effective leaders in the movement toward healthier leisure lifestyles, their personal leisure choices should be consistent with those they advocate (Simons-Morton, Greene & Gottlieb, 1995).

Introductory tests for professional preparation programs in recreation often include one or more chapters that address the role of recreation and leisure in achieving health and wellness in individuals and communities (Cordes & Ibrahim, 1999; Kraus, 1997; Russell, 1996). Recreation majors often spend their summers working for camps, resorts, parks and recreation departments and other settings in which the primary service population is the youth. They are expected to be role models to program participants. Upon graduation, many students find their first job place them in a direct leadership position where they are once again asked to be role models to participants. The question is whether recreation majors have the positive life and leisure habits they are asked to model. As the concept of wellness and the need to promote healthy leisure pursuits increases in society, the field of study in recreation and leisure needs to increase emphasis on the future professionals' pursuit of positive recreation and leisure activities.

The health and risk behaviors of university or college students are a growing concern to researchers and college professionals due to the increasing number of news reports related to violence, binge drinking episodes and use of other drugs in this community setting (Douglas et al., 1997; Sax, 1997). Students and researchers have noted other student health issues including nutrition, physical activity, tobacco use, sexual health, rape, violence, and stress (Sax, 1997). These concerns affect the students' health now and potentially in the future. Many students support strategies to reduce alcohol abuse on campus and see a need for implementation of these strategies (Gordon-Sosby, 2000). Students and faculty often see the need for education and enforcement of penalties or sanctions to reduce the health risks that are associated with alcohol and other drug use and abuse.

Factors, such as the lack of participation in stress reducing activities for many Americans are a concern for the future professional (NRPA, 2000a). Even though there has been greater emphasis placed on health and prevention of lifestyle diseases, the three major causes of morbidity and mortality in the United States for all racial and ethnic groups remain heart disease, cancer and stroke which primarily are caused by lifestyle behaviors (Centers for Disease Control and Prevention, 1977). The lifestyle behaviors that lead to these conditions are often established in youth and early adulthood. Factors that strongly influence each individual's overall health and the development of these and other health risk behaviors can be examined with the use of the National College Health Risk Behavior Survey (NCHRBS) developed by the Centers for Disease Control and Prevention (CDC). This questionnaire delineates six health risk categories to be examined: (1) behaviors that relate to unintentional and intentional injuries, (2) tobacco use, (3) alcohol and other drug use, (4) sexual behaviors, (5) dietary behaviors, and (6) physical activity behaviors (Callboy, Kann & Collins, 1993).

Studies examining the health risk behaviors for college students using the NCHRBS have been conducted across the nation (Douglas et al., 1997). These studies provide a snapshot of the students' health concerns thereby enabling professional programs and universities to address the unhealthy risks of their students. The purpose of this study was to examine the health risk behaviors of recreation majors in two four-year universities, one in Texas and one in North Carolina. Results from this and similar studies can be used to establish a baseline of information from which strategies to reduce the associated risks that are linked with the major causes of mortality and morbidity can be developed. Therefore, data from this study is of particular importance as recreation and leisure programs focus on wellness and the benefits of recreation and leisure to the future professional and to the community in which they work.

Participants in the study were recreation majors enrolled in recreation theory classes in the fall of 1998 in one of two state universities. The participants 268 majors (Texas N= 143, North Carolina N=125) voluntarily completed the questionnaire. This convenience sample included full and part-time students in both entry level classes and upper level classes. The response rate was 95%, and represents 59.6% of the total undergraduate recreation majors attending these two universities in the fall of 1998. 

The questionnaire used in this study was the NCHRBS developed by the CDC. To ensure face and content validity of the instrument, extensive field tests and focus groups have been conducted by the National Center for Health Statistics (Basen-Engquist, McPhillips-Tangum & Abro, 1994). Item reliability was estimated by the use of kappa statistics, with the mean kappas ranging from 61%-80% (Brener, Collins, Kann, Warren & Williams, 1995).

The questionnaire was administered between the second and fourth weeks of classes in both locations during a regularly scheduled class. All responses were anonymous. No student identifiers or names were used on the questionnaires. Responses were placed on a scannable answer sheet and each student placed the questionnaire and answer sheet in a box after they completed the questionnaire. 

Of the total respondents 90% classified themselves as White, 6% as Hispanic, and 2% as Black. Overall, half of the respondents were female, however by groups approximately 65% of the respondents from Texas and 33% of the respondents from North Carolina were females. Of the total respondents 3 percent of the students were 18 years of age or less, 16% were 19 to 20 years of age, 65% were 21 to 24 years of age, and 16% were 25 years of age or older. In Texas, 2 percent of the respondents were 18 years of age or less, 12% were 19 to 20 years of age, 69% were 21 to 24 years of age, and 17% were 25 years of age or older. In North Carolina, 5 percent of the respondents were 18 years of age or less, 20% were 19 to 20 years of age, 61% were 21 to 24 years of age, and 14% were 25 years of age or older. More than 85% percent of the respondents in both groups had never been married. Table 1 has a comparison between these two response groups and the respondents in the NCHRBS (Douglas et al., 1997).

The percentage of the total respondents who had been in a physical fight during the last 12 months was 13.8%. When asked "The last time you were in a physical fight, with whom did you fight?" the three most commonly identified sets of individuals that the respondents had been in a physical fight with were: 1). a friend or an acquaintance (Texas = 9.9%, North Carolina = 22.4%), 2). a total stranger (Texas = 10.6%, North Carolina = 20.8%), and 3). a parent, brother, sister or other family member (Texas = 6.3%, North Carolina = 4%).

Suicide

Respondents were asked if during the past 12 months they had ever seriously considered attempting suicide, overall 6% indicated they had. More than 5% indicated they had made a plan about how to attempt suicide. In addition, 5.2% of the total respondents had actually attempted suicide. Overall, 1.9% (Texas = 1.4%, North Carolina = 2.4%) of the respondents had made an attempted suicide that resulted in injury, poisoning or overdose that required them to be seen or treated by medical personnel. (Table 2 lists selected recreation data in comparison with the national data).

Almost 100% of the respondents indicated that they drive a car; only two respondents indicated that they do not drive a car. Of the respondents who drive a car less than three-fourths, only 68% (Texas = 68.5%, North Carolina = 67.2%), indicated that they "always" wear a seatbelt when driving. Furthermore, only 54% (Texas = 60.1%, North Carolina = 46.4%) of the total respondents indicated that they "always" wear a seatbelt when they are passengers in a vehicle. Approximately 4.9% (Texas = 4.9%, North Carolina = 4.8%) indicated they never or rarely used a seatbelt when they drove, this is less than the national results of 9.2%.

Another area for concern in unintentional injuries is the consumption of alcohol while driving or in the pursuit of recreation or leisure activities. Approximately 56% of the total respondents indicated that during the last 30 days they had consumed alcohol and driven a vehicle. In addition, 41% of the respondents from Texas and 36% of the respondents from North Carolina indicated they had driven a vehicle more than two times in the last 30 days when they had been drinking alcohol. Overall, 62% of the respondents indicated that in the last 30 days they had ridden in a vehicle in which the driver had been drinking alcohol. In the area of recreation or leisure activities and alcohol use, 90.7% of the respondents reported that they had been boating or swimming during the past 12 months, and approximately half had used alcohol while participating in boating or swimming activities. A comparison of data for the recreation majors and the NCHRBS (Douglas et al., 1997) is on Table 3.

Approximately 81% of the respondents reported that during their lifetime they had tried cigarette smoking; this included taking even one or two puffs. Almost 40% of the respondents indicated they had been a regular smoker at some point in their lifetime, smoking at least one cigarette every day for at least 30 days. Currently more than 42% of the respondents reported they had smoked cigarettes on one or more of the past 30 days, and 17.9% reported they had smoked on 20 or more of the past 30 days. In addition, 13.4% indicated they had used chewing tobacco or snuff during the past 30 days. Table 3 lists selected recreation data in comparison with the NCHRBS (Douglas et al., 1997).

Almost 96% of the respondents reported they had tried drinking alcohol, with over 84% reporting that they had consumed at least one drink containing alcohol in the past 30 days. This included the 12% who reported drinking at least one drink on 20 or more of the past 30 days. Furthermore, overall 2.2% (Texas = 0.7%, North Carolina = 4.0%) reported they had consumed 5 or more drinks of alcohol within a couple of hours on 20 or more days during the past 30 days.

Of the total respondents nearly 72% indicated that during their lifetime they had tried marijuana, and 34.7% indicated that during the past 30 days they had used marijuana at least once. Over 27% of the total respondents indicated they had tried cocaine, crack, or freebase during their lifetime at least once, with 7.5% (Texas = 7.0%, North Carolina = 8.0%) having used some form of cocaine during the past 30 days. In addition, 7.8% (Texas = 7.0%, North Carolina = 8.8%) of the respondents indicated they had injected illegal drugs before. When asked to indicate the lifetime use of any other type of illegal drug, such as LSD, PCP, ecstasy, mushrooms, speed etc., approximately 45% (Texas =38.4%, North Carolina = 52%) of the respondents reported they had used these types of drugs at least once in their lifetime. Table 3 lists selected recreation majors' data in comparison with the NCHRBS(Douglas et al., 1997).

Of the total student respondents 84% indicated they had been sexually active during their lifetime. In addition, almost 29% (Texas = 25.9%, North Carolina = 32.0%) had used alcohol or drugs prior to sexual intercourse the last time they had been sexually active. Approximately, 36% (Texas = 43.6%, North Carolina = 28.5%) reported the most commonly used method of contraception was birth control pills. Furthermore, 14% of the respondents in Texas and 4% of the respondents in North Carolina reported ever being told by medical personnel that they had a sexually transmitted disease, such as herpes, genital warts, gonorrhea, or HIV infection. When asked if they had changed their personal behavior because of concern about HIV infection 43.7% of the Texas respondents and 57.6% of the North Carolina respondents indicated they had not. Table 4 lists selected recreation data in comparison with the NCHRBS (Douglas et al., 1997).

*Indicates the percent of respondents that had ever had sexually intercourse.

More than 50% (Texas = 51%, North Carolina = 52%) of the respondents reported they perceived themselves to be "about the right weight." During the past 7 days to keep from gaining weight or to lose weight 15.5% (Texas = 16.8%, North Carolina = 14.5%) of the total respondents reported a combination of both diet and exercise to control their weight. However, during the past 7 days 0.4% (Texas = 0%, North Carolina = 0.8%) had used both vomiting and diet pills to keep from gaining weight.

Of the total respondents, approximately, 38% (Texas = 41.3%, North Carolina = 35.5%) had eaten cooked vegetables at least once the day before. In addition, more than 29% of the total respondents (Texas = 27.2%, North Carolina = 31.5%) had eaten a green salad at least once the day before. However, more than 42% of the total respondents reported (Texas = 39.9%, North Carolina = 45.9%) they had consumed french fries or potato chips on the day before. Approximately 28% (Texas = 24.5%, North Carolina = 31.5%) reported eating foods normally high in fat such as hamburger, hot dogs, or sausage on the previous day. Table 5 lists selected recreation data in comparison with the NCHRBS (Douglas et al., 1997)^.

Sixty percent of the respondents indicated that during the past 7 days on three or more days they had participated in sports activities for at least 20 minutes that made them sweat and breathe hard. Approximately half of the respondents also indicated that in the past 7 days on three or more days they had walked or bicycled for at least 30 minutes at a time (Texas = 49.3%, North Carolina = 50%). However, 17.9% (Texas = 19.7%, North Carolina = 16.1%) of the respondents indicated they had not participated in any activity during the past 7 days that made them sweat or breathe hard. Table 5 lists selected recreation data in comparison with the NCHRBS (Douglas et al., 1997)^.

In examining the responses to the NCHRBS (Douglas et al., 1997) it is important to be aware of the limitations of this study. This study utilized a convenience sample and the respondents, who were declared recreation majors enrolled in one of the two universities, may not be representative of all recreation majors. Another limitation is the fact that a greater percentage of respondents in this study were younger than the respondents in the NCHRBS (Douglas et al., 1997) study. Nonetheless, these findings contribute basic descriptive data in the area of health risk behaviors and raise some specific concerns about the need to examine the risk behaviors of students who are recreation majors. There are several areas in which the respondents partake in risky behaviors that place them at a high risk for injuries, illnesses, or legal consequences.

In a comparison of the respondents in this study and the results from national study there are some demographic and behavioral differences. Overall the respondents in this study were half females (Texas = 65%, North Carolina = 33%). In this study more than 85% of the respondents from either state classified themselves as White whereas the respondents in the 1995 NCHRBS approximately three-fourths were White. In addition, approximately 20% more of the respondents in this study classified themselves in the 18-24 years of age range and as "never married."

One of the health risk behavior areas of concern for this group is in the area of intentional injuries. A higher percentage of recreation majors from North Carolina indicated they had been in a physical fight in the past year when compared to the national percentages. The higher percentage could be reflective of the larger percentage of males respondents in North Carolina. However, in the area of suicide, fewer of the recreation majors' from North Carolina compared to the national percentages had considered attempting suicide or made a plan for attempting suicide in the past 12 months. Although fewer respondents had considered suicide, a higher percentage of the recreation majors, from both states, had attempted suicide and almost four times the national percentage indicated that the attempted suicide had resulted in the need for medical treatment.

A second major area of risky behavior that is of concern is the area of alcohol and other drug use, including tobacco. The recreation majors had a higher tobacco use in regular lifetime use, smoking in the last 30 days, and in the use of smokeless tobacco use in the last 30 days. The respondents from North Carolina reported higher tobacco use, both lifetime and in the past 30 days, when compared to the national percentages. This finding may be reflective of North Carolina's status as a "tobacco state."

The results for both states in the area of alcohol use is a major concern due to potential injury to themselves and/or others, and potential legal consequences. Of particular concern are the results in the area of binge drinking, consuming 5 or more drinks on at least one occasion, which indicated the respondents were 24% to 34% higher in this area than the national respondents. In addition, the percentage of respondents in this study that had consumed at least one drink and driven in the past 30 days was 24% to 33% higher than the NCHRBS respondents. Furthermore, both sets of respondents have a higher use of alcohol in the past 30 days during boating and swimming. Alcohol use and abuse is one area where universities can establish policies and educational strategies for their students to encourage the reduction of consumption of alcohol. In addition, experimentation and use of other drugs is also of concern, two examples of this are the trial and use of marijuana and cocaine. All of these unhealthy risk behaviors can and should be addressed in the university settings.

In the area of sexual behaviors, the recreation majors from both states were only slightly higher in one risky behavioral area, the number of respondents who had more than six sexual partners in their lifetime. One area that indicated a positive health behavior was in the area of condom use; the recreation majors' percentages from both states indicated use of condoms during their last sexual intercourse at a higher rate than the national percentages. However, the use of a condom does not guarantee individuals protection against all sexually transmitted diseases.

The recreation majors' health risk behaviors in the area of dietary habit and physical activity are mixed. The percentage of recreation majors' who reported using weight control methods is less than the national average. However, this could be due to the fact that more than 50% of the respondents had indicated they felt they were about the right weight. The nutrition responses from recreation majors in both states are similar to the national averages. However, in the area of physical activity the recreation majors indicated that they were more physically active than the reported national respondents. In addition, in North Carolina almost twice the percentage of the national respondents indicated that they had walked or bicycled for at least 30 minutes on at least 5 of the past 7 days. North Carolina majors include those with an emphasis in outdoor experiential education. Many of the students are drawn to the program because of their personal interest in activities such as hiking, biking, climbing, and other outdoor activities.

From examining this data, the major health risk concerns for this group are unintentional injuries, intentional injuries, tobacco use, and alcohol and other drug use. In these areas the recreation majors indicated a greater percentage of risky behaviors than the 1995 NCHRBS (Douglas et al., 1997) respondents. Several of these findings could be of concern due to the fact that health risk behaviors may be dominating the recreation majors' leisure pursuits. Specific examples include the use of illegal drugs and the prevalence of binge drinking. These health risk behaviors are important to address in that many of the health behaviors developed in the professional preparation setting may be set for life.

Colleges and universities need to continue to focus on means of developing healthy communities for their students. This includes the use of peer education programs, the establishment of easily accessible health resources, and a community focused on a healthy environment. These concepts are not new (Gates & Kennedy, 1989; Grace, 1997; Jackson & Weinstein, 1997) however, the implementation of the strategies needed to make the environment focus on developing the healthy adult are not always in place. Studies aiding in the identification of risky behavior specific to each community's population, such as this study, can be a step in that direction and should be used as a tool to assist program development which focuses on a healthy environment and community.

Unhealthy risk behaviors have consequences for all involved. Individuals who partake in risky sexual behaviors, have multiple partners, and/or the lack of or inconsistent use of, a latex condom, put themselves and others in danger of unwanted pregnancy or sexually transmitted diseases, such as chlamydia or the human immunodeficiency virus. In addition, the use and abuse of alcohol carries with it the potential of increased violence, alcoholism, unplanned sexual encounters, and possibly arrest. Aside from the personal and legal consequences of risk behaviors to the individual, there are professional consequences. Professionally, consequences include difficulty, or the inability to obtain employment with a criminal record for a drug offense. Therefore, unhealthy risk behaviors are a major concern.

As noted previously, numerous recreation providers seek to contribute to the well-being of individuals and community. The future of the profession rests in the hands of today's recreation majors. Results of this study raise the question of whether, as professionals, they will understand the importance of providing meaningful, positive leisure opportunities.

Differences in the recreation majors' data and the national data could be a reflection of the personality of individuals drawn to a major in recreation which is often viewed as 'fun' or 'play' and may attract those predisposed to these risk behaviors. Further research is needed to examine the trends and reasons for negative health behaviors in this major and to determine if this trend is reflected in the majority of recreation majors. If this trend is widespread, it presents a challenge to recreation faculty and professionals. Perhaps greater emphasis in the recreation curriculum should be given to helping students understand the importance of developing positive leisure lifestyles for themselves and others.

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