A Governor's Transformation

1. A Governor's Transformation

2. A Governor's Transformation We can prevent this! • June 2003 • “Personal Health Crisis” • “Wake-Up Call” • Chest-pain scare • Adult onset diabetes • Doctor said much worse trouble lay ahead • Shed 105 pounds • Using every forum to talk about healthy living • State of public health • Draining state treasury • Weakening the economy

3. A Governor's Transformation • Huckabee turns private crusade into public policy • “The health care system is really designed to reward you for being unhealthy.” • "If you are a healthy person and work hard to be healthy, there are no benefits.“ “He's hoping to come up with financial and other incentives to change that.”

4. Healthy Arkansas “We have reached a point in time that we simply have to start to address behavioral issues when we talk about the general health and well-being of any group of people.” ★ Increased productivity by 2 to 52 percent www.arkansas.gov/ha/pdf/community_brochure.pdf "I didn't go on a diet as much as I changed a bad lifestyle. You can do it too!“ Governor Mike Huckabee

5. Helping Policymakers Discover the Health and Productivity Academic Performance Connection Health & Productivity Management (HPM) Health & Academic Performance Management (HAPM) Jim Grizzell, MBA, MA, CHES Cal Poly Pomona and Loma Linda University

6. Objectives • Explain reasons why leaders are not supportive of evidence-based and effective health promotion • List and describe five indicators of a healthy campus community • Compare the relationship between health and productivity and academic performance • Describe how leaders might be influenced to have a greater belief that there is a strong connection between health and productivity

7. Reasons Why Leaders are Not Supportive of Health Promotion • Have limited understanding of what health promotion is all about. • Think in terms of a “health care agenda” instead of a “health agenda,” • Do not understand the personal relevance of good health in their own lives • Don’t believe there is a strong relationship between health and productivity (academic performance). • Don’t believe anything can be done to change behaviors.

8. Definitions of Health & Productivity Management - #1 The integration of all organizational human capital/resource-related departments designed to accomplish a comprehensive approach to reducing or eliminating health and injury risks while enhancing the portion of personal performance that is related to health. http://www.ahpm.org/

9. Definitions of Health & Productivity Management - #2 The integrated management of health and injury risks, illness, and disability to reduce students’ total health-related costs including direct medical expenditures, unnecessary absence from class, poor academic performance in class (presenteeism) and when studying. Adapted from http://www.ihpm.org/

10. Presentation Relationship toACHA Standards • Standards of Practice for Health Promotion in Higher Education • Effective practice of health promotion in higher education requires practitioners to understand and apply • professionally recognized and tested theoretical approaches that address individual and community health. • evidence-based approaches to health promotion.

11. Transtheoretical Modelof Individual Change Use stage matched messages to move to “Action”

12. Transtheoretical Modelof Organizational Change

13. Models & Frameworks • NASPA’s Leadership for a Healthy Campus • Higher Education Center • Center for College Health & Safety • PRECEDE – PROCEDE • Logic Model • Intervention Mapping • Interactive Domain Model

14. Precontemplative Not seriously considering change Awareness, concern, confidence Contemplative Thinking about change Risk-Reward analysis, decision Preparation Getting ready to make change NCHA, measurable objectives, evidence-based plan Action Making the change Implement plan Maintenance Sustaining behavior Integration into lifestyle Stages of Change Descriptions and Tasks

15. Pros & Cons of Change and Stages of Changes 70%22% 7% 1%

16. Reasons Why Leaders are Not Supportive of Health Promotion • Have limited understanding of what health promotion is all about. • Think in terms of a “health care agenda” instead of a “health agenda.” • Do not understand the personal relevance of good health in their own lives • Don’t believe there is a strong relationship between health and productivity (academic performance). • Don’t believe anything can be done to change behaviors.

17. Historical SnapshotCorporate & College Health Promotion 1st Generation 2nd Generation 3rd Generation 4th Generation RecreationFitnessHealth Promotion HPM 1850s 1970s 1980s ~1995 2010 1st Generation 2nd Generation 3rd Generation Instruction, Treatment, ExerciseHealth Education > Promotion HAPM

18. Reasons Why Leaders are Not Supportive of Health Promotion • Have limited understanding of what health promotion is all about. • Think in terms of a “health care agenda” instead of a “health agenda,” • Do not understand the personal relevance of good health in their own lives and • Don’t believe there is a strong relationship between health and productivity (academic performance). • Don’t believe anything can be done to change behaviors.

19. “Think Health Agenda instead of Health Care Agenda.” “One of the most-cited statistics in public health is the imbalance of social investments in medical care compared with prevention activities. Approximately 95% of the trillion dollars we spend as a nation on health goes to direct medical care services, while just 5%is allocated to population wide approaches to health improvement. However, some 40 percent of deaths are caused by behavior patterns that could be modified by preventive interventions.” McGinnis, J. M, Williams-Russo, P and Knickman, J. The Case For More Active Policy Attention To Health Promotion. Health Affairs, (2) 1, 2, p 78-93.

20. Broad Picture of Health

21. Reasons Why Leaders are Not Supportive of Health Promotion • Have limited understanding of what health promotion is all about. • Think in terms of a “health care agenda” instead of a “health agenda.” • Do not understand the personal relevance of good health in their own lives. • Don’t believe there is a strong relationship between health and productivity (academic performance). • Don’t believe anything can be done to change behaviors.

22. A Governor's Transformation We can prevent this! • June 2003 • “Personal Health Crisis” • “Wake-Up Call” • Chest-pain scare • Adult onset diabetes • Doctor said much worse trouble lay ahead • Shed 105 pounds • Using every forum to talk about healthy living • State of public health • Draining state treasury • Weakening the economy

23. Personal Importance & Urgency

24. Activity • Health and Productivity Connection Questionnaire • Developed by Molly McCauley, RN, MPH, CHES • Director AT&T Health Promotion • Past President Society for Public Health Education (SOPHE) • Work Well Health Assessment

25. Reasons Why Leaders are Not Supportive of Health Promotion • Have limited understanding of what health promotion is all about. • Think in terms of a “health care agenda” instead of a “health agenda,” • Do not understand the personal relevance of good health in their own lives • Don’t believe there is a strong relationship between health and productivity (academic performance). • Don’t believe anything can be done to change behaviors.

26. Healthy Campus 2010Top 10 Health Impediments to Learning

27. Comparisons to BusinessBank One

28. Comparisons to BusinessBank One

29. Healthy Campus 2010Receipt of Information from IHE

30. Healthy Campus 2010Top 10 Physical & Mental Health Problems

31. Activity • Pros & Cons of Healthy Campus Initiative

32. Reasons Why Leaders are Not Supportive of Health Promotion • Have limited understanding of what health promotion is all about. • Think in terms of a “health care agenda” instead of a “health agenda,” • Do not understand the personal relevance of good health in their own lives. • Don’t believe there is a strong relationship between health and productivity (academic performance). • Don’t believe anything can be done to change behaviors.

33. Visualize a Healthier Campus by Using the Targets • Increased retention and higher grade point averages can be achieved • Accomplish with a Healthy Campus Initiative • Composed of a variety of simultaneous long-term and institutionalized collaborative campus-wide interventions

34. Healthy Campus 2010: Health Impediment to LearningStress

35. Use of Ecological approach includes Mandatory general education courses personal health & consumer stress management courses Social marketing College / school / group targeted interventions Policies Achieve Healthy Campus 2010 “Stress”objectivetarget of 25%(from a baseline of 28.4%) 340 fewer students receiving lower grade or dropping classes 2,500 instead of 2,840 12% reduction Visualize a Healthier Campus by Using the Targets NOTE: for campus with 10,000 students

36. Ecological ApproachEnvironmental Influences Place People Location of the campus Weather Constructed designs, the “built environment” Landscapes Behavior settings: Rituals, student organizations Cultural Influences: Customs, traditions, values Economic Forces: Student financial stability, budget Inhabitants: Diversity, Athletics, Greek, campus communities, etc. Organizational Structure Policies Organizational climate Organization Community Political climate Conservative/liberal Pro education? Reinforcement and rewards for healthy org & indiv behaviors

37. Stress Objective Environmental Influences Warm climate Lack of parking High traffic Campus size—distances Crowding—long lines Place People Financial concerns ISO – global troubles Relationships w/friends Lack of friends/commuters Irresponsible drinkers Uninvolved students Services--lack of info Depts disconnected Too many steps Weak policy enforcement Inconsistent messages Institution State budget crisis Increase in tuition/fees Rewards for over commitment Culture of stress Community

38. Healthy Campus 2010 Health Impediment to LearningCold/Flu/Sore Throat

39. Healthy Campus 2010: Health Impediment to LearningAlcohol Use

40. Achieve Healthy Campus 2010 “Cold / flu / sore throat”objectivetarget of 12% (from a baseline of 21%) 1000 fewer students receiving lower grade or dropping classes 1,200 instead of 2,200 45% reduction Achieve Healthy Campus 2010 “Alcohol”objectivetarget of 2.5%(from a baseline of 8%) 550 fewer students receiving lower grade or dropping classes 250 instead of 800 69% reduction Visualize a Healthier Campus by Using the Targets NOTE: for campus with 10,000 students

41. Activity • Ecologic Assessment

42. Resources • Institute for Health and Productivity Management • www.ihpm.org • Academy of Health and Productivity Management • www.ahpm.org • Wellness Council of America • www.welcoa.org • Health Behavior and Health Education: Theory, Research and Practice • Karen Glanz, Barbara Rimer, Frances Lewis • This PowerPoint • www.csupomona.edu/~jvgrizzell/hc2010/acha05nho