College Health: Stretch Your Definition of the Core Concepts, Assumptions and Practices

1. 1 College Health:Stretch Your Definition of the Core Concepts, Assumptions and Practices Lesley Sacher, Karen Moses, Pat Fabiano, Jenny Haubenreiser, Jim Grizzell, Sarah Mart NASPA session March 22, 2005, 3:15 � 4:30 Timeline3:15 call to order - Paula and Jane Presider and Facilitator3:15 to 3:20 Introduction - Lesley3:20 to 3:30 Ecological Model - Karen3:30 to 3: 40 Standards - Patricia3:40 to 3:50 NCHA - Jenny3:50 to 4:00 HC2010 - Jim4:00 to 4:10 Application - Sarah4:10 to 4:30 Q and A NASPA session March 22, 2005, 3:15 � 4:30 Timeline3:15 call to order - Paula and Jane Presider and Facilitator3:15 to 3:20 Introduction - Lesley3:20 to 3:30 Ecological Model - Karen3:30 to 3: 40 Standards - Patricia3:40 to 3:50 NCHA - Jenny3:50 to 4:00 HC2010 - Jim4:00 to 4:10 Application - Sarah4:10 to 4:30 Q and A

2. 2 Introduction

3. 3 NASPA: Health in Higher Education Knowledge Community We recognize that health and learning are interdependent. We recognize a broad definition of health. We recognize that there are tools for change.

4. 4 Introduction A transformational model for campus communities An integrated approach Expands the traditional and historical perspective of health on campus We will ask the question Who needs to �own� health on campus?

5. 5 Introduction Health Transcends the runny noses and sore throats of an infirmary within four walls. Embraces the mission of the university Keeps students healthy so they can keep their academic promise Embraces the whole campus Environmental context Improves the community in which faculty, staff and students live, work and play

6. 6 Introduction The Model Evidence based and data driven Creates systems of care Student focused Partnership driven

7. 7 Health in Higher Education

8. 8 Health in Higher Education Health, in its broadest sense, serves to support students and create learning environments. A wide range of college and university professionals work in higher education to promote health. Programs and policies surrounding issues such as alcohol and other drug use, sexual misconduct, and mental health are increasingly viewed as campus wide issues that affect the health of students and academic progress. Advancing the health of college students influences the quality and productivity of their lives in the�workplace and in the community.

9. 9 Traditional Health Programs Use the Medical Model Health services has primary responsibility Focus is on the physical Healing sickness/injury Wellness for physical health Methods focus on the individual Education, information, awareness

10. 10 The Traditional Approach Limits our understanding of health Physical health is what counts most Ignores role of environment/community on health and well being Lacks prevention focus Financially costly Removes responsibility for health outcomes by non-health entities Gives medical systems a lot of power

11. 11 The Ecological Perspective The science and art of helping people change their lifestyle to move toward a state of optimal health�.Lifestyle change can be facilitated through a combination of efforts to enhance awareness, change behavior, and create environments that support good health practices. Of the three, supportive environments will probably have the greatest impact in producing lasting changes. M. P. O�Donnell, American Journal of Health Promotion (1986)

12. 12 A New Paradigm: The Ecological Approach to Campus Health Views the connections among health, learning, and the campus structure Explores relationships between and among individuals and the learning communities that comprise the campus environment

13. 13 Using the Ecological Perspective on Campus Establish a Working Group Identify Campus Values Assess Student Health Data Analyze Campus Health Concerns Through an Ecological Lens Environmental influences Individual influences Develop a Plan

14. 14 Influencing Factors Notes: Comprehensive, multifaceted, HOLISTIC, concerned with the environment and its relationship to people at individual, interpersonal, organizational and community levels. Recognizes that these interactions INFLUENCE behavior and well being. Notes: Comprehensive, multifaceted, HOLISTIC, concerned with the environment and its relationship to people at individual, interpersonal, organizational and community levels. Recognizes that these interactions INFLUENCE behavior and well being.

15. 15 Environmental Influences

16. 16 Stress: Environmental Influences

17. 17 Keys to Effective Use of the Ecological Perspective Expand the focus beyond health information and programming Integrate responsibility for health across student affairs and academic units Provide supportive environments and reduce barriers to optimal outcomes Promote leadership and involvement by multiple partners

18. 18 Health in Higher Education

19. 19 Healthy Campus Community

20. 20 Campus wide health promotion collaborators Health educators Residence life staff Faculty Nurses Student activities staff Student Leaders Campus recreation center staff Deans of Students offices Judicial officers Counselors Physicians University police Health in Higher EducationA Campus Wide Approach

21. 21 Reframing Student Affairs Collaborators for A Healthy Campus

22. 22 Health Promotion/Education in Higher Education Health promotion in higher education is moving into a new era evidence-based cost-effective culturally competent data-driven and research-based strategies for advancing the health of students and the well being of campus communities

23. 23

24. 24 Standards of Practice, Revised 2004

25. 25 Standards of Practice, 2005 Context Situates the Standards within the academic and student affairs mission of higher education Includes and invites multidisciplinary practitioners of health promotion in higher education

26. 26 Philosophical foundation includes: A broad definition of health The connection between individual and community health The connection between health and social justice The need for individual and environmental approaches The connection of between health and learning Standards of Practice, 2005

27. 27 Standards of Practice, Revised 2004

28. 28 Mission of Higher Education Collaborative Practice Cultural Competence Theory-Based Practice Evidence-Based Practice Professional development Standards of Practice, 2005

29. 29 Next Steps Standards, Revised 2005 on ACHA web site http://www.acha.org/info_resources/SPHPHE_statement.pdf Vision Into Action: Tools for Professional and Program Development Based on the Standards of Practice for Health Promotion in Higher Education (May 2005) Translation of ACHA Standards, Revised 2004 into CAS* Standards for Health Promotion Services differentiated from college health program clinical medicine standards with publication goal of 2006 * Council for the Advancement of Standards in Higher Education

30. 30 Translation of Standards for Health Promotion Practice into Standards for Higher Education

31. 31 ACHA - National College Health Assessment

32. 32 ACHA - National College Health Assessment: Information, Advocacy, Action

33. 33 NCHA: Broad Definition of Health General health, health education, safety indicators Alcohol and other drugs Violence Weight, nutrition, exercise Sexual behaviors, perceptions, contraception Mental and physical health Impediments to learning Other factors affecting campus health Insurance, sleep, credit card debt Other factors, internet use, cold/flu/sore throat (Other factors, internet use, cold/flu/sore throat (

34. 34 NCHA: Campus Use Identify university retention and mission objectives Identify health impediments to learning Risk & protective factors Prevalence data Prioritize health care Allergies, back pain, sinus infections, depression Identify healthy campus initiatives Healthy Campus 2010 SPHPHE Ecological framework Evaluate strategies

35. 35 NCHA: Aggregate Spring 2004 Data 74 IHEs N = 47,202 Female: 65% Age (mean) Females: 22.2 Males: 22.3 Race/ethnicity non-white: 27% Year in school First year: 24% Second year: 22% Third year: 21% Fourth year: 17% Other/grad: 16% Campus residence hall: 35% Married: 14%

36. 36 Aggregate NCHA Data: Spring 2004 (N=47,202)American College Health Association. National College Health Assessment Web Summary. Updated June 2004. Available at http://www.acha.org/projects_programs/ncha_sampledata_mbrs.cfm.2004 From Members Only web pageFrom Members Only web page

37. 37 Aggregate NCHA Data: Spring 2004 (N=47,202)American College Health Association. National College Health Assessment Web Summary. Updated June 2004. Available at http://www.acha.org/projects_programs/ncha_sampledata_mbrs.cfm.2004 From Members Only web pageFrom Members Only web page

38. 38 Aggregate NCHA Data: Spring 2004 (N=47,202)American College Health Association. National College Health Assessment Web Summary. Updated June 2004. Available at http://www.acha.org/projects_programs/ncha_sampledata_mbrs.cfm.2004 From Members Only web pageFrom Members Only web page

39. 39 Aggregate NCHA Data: Spring 2004 (N=47,202)American College Health Association. National College Health Assessment Web Summary. Updated June 2004. Available at http://www.acha.org/projects_programs/ncha_sampledata_mbrs.cfm.2004 From Members Only web pageFrom Members Only web page

40. 40 Aggregate NCHA Data: Spring 2004 (N=47,202)American College Health Association. National College Health Assessment Web Summary. Updated June 2004. Available at http://www.acha.org/projects_programs/ncha_sampledata_mbrs.cfm.2004 2003 data Ear infection ~9% Repetitive Stress Injury ~9% 2003 data Ear infection ~9% Repetitive Stress Injury ~9%

41. 41 Healthy Campus 2010: Making It Happen

42. 42 Healthy People 2010 & Healthy Campus 2010 Comprehensive sets of national health objectives for the decade Developed by a collaborative process Designed to measure progress over time Public and college health documents part strategic plan part textbook on national and college health priorities There are three motivational mechanisms by which setting goals has beneficial effects on performance: effort, persistence and concentration. Setting high goals has cognitive, in addition to motivational, benefits in terms of stimulating strategic analysis. Strategic analysis in this case refers to a cognitive activity that breaks down a goal into a concise series of tasks that can be approached in a stepwise manner. These tasks, in turn, can be framed as �proximal goals� or subgoals. A goal may be strategically analyzed either by health promotion or workgroup staff, or with the assistance from an outside agent. Either way, the function of strategic analysis is to develop and orchestrate a series of subgoal in the process of aching a longer term goal. Subgoals cue persons to use certain strategies that respond to effort. When persons work on distal or long-term goals subgoals may also provide them with frequent feedback and may be more psychologically �real� than more global, complex or distal goals. Subgoals are more tangible and can in this manner prevent hesitation or postponement of goal-related activities. Setting subgoals makes the reward come sooner Setting subgoals also appear to enhance self-efficacy and satisfaction with performance. Stretcher, V., Seijts, G., Kok, G., Latham, G., Glasgow, R., DeVellis, B., Meertens, R., Bulger, D. (1995). Goal Setting as a Strategy for Health Behavior Change. Health Education Quarterly. 22(2) 190-200.There are three motivational mechanisms by which setting goals has beneficial effects on performance: effort, persistence and concentration. Setting high goals has cognitive, in addition to motivational, benefits in terms of stimulating strategic analysis. Strategic analysis in this case refers to a cognitive activity that breaks down a goal into a concise series of tasks that can be approached in a stepwise manner. These tasks, in turn, can be framed as �proximal goals� or subgoals. A goal may be strategically analyzed either by health promotion or workgroup staff, or with the assistance from an outside agent. Either way, the function of strategic analysis is to develop and orchestrate a series of subgoal in the process of aching a longer term goal. Subgoals cue persons to use certain strategies that respond to effort. When persons work on distal or long-term goals subgoals may also provide them with frequent feedback and may be more psychologically �real� than more global, complex or distal goals. Subgoals are more tangible and can in this manner prevent hesitation or postponement of goal-related activities. Setting subgoals makes the reward come sooner Setting subgoals also appear to enhance self-efficacy and satisfaction with performance. Stretcher, V., Seijts, G., Kok, G., Latham, G., Glasgow, R., DeVellis, B., Meertens, R., Bulger, D. (1995). Goal Setting as a Strategy for Health Behavior Change. Health Education Quarterly. 22(2) 190-200.

43. 43 Healthy Campus 2010Top 10 Health Impediments to Learning Visualize a Healthier Campus by Using the Targets Increased retention (decreased attrition) and higher grade point averages can be achieved. These can be accomplished with a Healthy Campus initiative. The initiative is composed of a variety of simultaneous long-term and institutionalized collaborative campus-wide interventions. Examples of simultaneous interventions include mandatory personal health and stress management courses, social marketing, college/school/group specific targeted interventions, and policies. Example � If a university with 10,000 students achieved the Health Campus 2010 target on the �Stress� Retention Objective of 1.4% (from a baseline of 1.8%) o the university would have 40 fewer students who dropped a course ?? 140 instead of 180 and o a 22% reduction in drops and incompletes the past year. � If the university achieved the Healthy Campus 2010 target of the �Stress� Mission Objective of 25% (from a baseline of 28.4%) o the university would have 340 fewer students who received any lower grade or dropped ?? 2,500 instead of 2,840 and o a 12% reduction in lower grades in the past year. Visualize a Healthier Campus by Using the Targets Increased retention (decreased attrition) and higher grade point averages can be achieved. These can be accomplished with a Healthy Campus initiative. The initiative is composed of a variety of simultaneous long-term and institutionalized collaborative campus-wide interventions. Examples of simultaneous interventions include mandatory personal health and stress management courses, social marketing, college/school/group specific targeted interventions, and policies. Example � If a university with 10,000 students achieved the Health Campus 2010 target on the �Stress� Retention Objective of 1.4% (from a baseline of 1.8%) o the university would have 40 fewer students who dropped a course ?? 140 instead of 180 and o a 22% reduction in drops and incompletes the past year. � If the university achieved the Healthy Campus 2010 target of the �Stress� Mission Objective of 25% (from a baseline of 28.4%) o the university would have 340 fewer students who received any lower grade or dropped ?? 2,500 instead of 2,840 and o a 12% reduction in lower grades in the past year.

44. 44 Healthy Campus 2010: Health Impediment to LearningStress Target setting method: National: College: Better than the best (Black = 25.5%). Our Campus: Better than the best (Black = 21.4%). Target setting method: National: College: Better than the best (Black = 25.5%). Our Campus: Better than the best (Black = 21.4%).

45. 45 Healthy Campus 2010 Health Impediment to LearningCold/Flu/Sore Throat Cold/flu/Sore throat Target setting method: National: College: Better than the best (Black = 12.6%). Our Campus: Better than the best (Black = 14.3%). Cold/flu/Sore throat Target setting method: National: College: Better than the best (Black = 12.6%). Our Campus: Better than the best (Black = 14.3%).

46. 46 Healthy Campus 2010: Health Impediment to LearningAlcohol Use Alcohol Target setting method: National: College: Better than the best (Black = 2.6%). Our Campus: Better than the best (Black = 0.0%, Hispanic = 3.2%). Alcohol Target setting method: National: College: Better than the best (Black = 2.6%). Our Campus: Better than the best (Black = 0.0%, Hispanic = 3.2%).

47. 47 Healthy Campus 2010Receipt of Information from the IHE Even though every university is required and does �inform� all faculty, staff and students of AOD problems and resources for help per Federal Department of Education requirements less than 50% of students recall having received information!!!!! Even though every university is required and does �inform� all faculty, staff and students of AOD problems and resources for help per Federal Department of Education requirements less than 50% of students recall having received information!!!!!

48. 48 Putting It Together

49. 49 Putting It Together One model: Ecological approach Three tools: NCHA, SPHPHE, HC2010 One example of a process for using these: The University of San Francisco

50. 50 Strategic planning &implementation

51. 51 Defining the problem(s) Which health issues negatively impact academic performance? Which of those health issues are experienced most often, by the most students? Which health issues are contributors to the academic mission of the institution?

52. 52 USF Student Health Issues

53. 53 University of San Francisco

54. 54 SUMMARYNASPA: Health in Higher Education Knowledge Community Health and learning are interdependent. Health includes both individual and environmental influences. Useful tools are available to lead change initiatives with our campuses.

55. 55 Slide Show URL