A Governors Transformation 1 A Governors Transformation e

A Governor's Transformation 1

A Governor's Transformation ¢ e W n a c t n e v e r p ! s i h t June 2003 l l l l ¢ “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 l l Draining state treasury Weakening the economy 2

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. ” 3

Healthy Arkansas "I didn't go on a diet as much as I changed a bad lifestyle. You can do it too!“ Governor Mike Huckabee 4 “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

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 5

Objectives ¢ ¢ 6 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

Reasons Why Leaders are Not Supportive of Health Promotion ¢ ¢ ¢ 7 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.

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/ 8

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/ 9

Presentation Relationship to ACHA Standards ¢ ¢ Standards of Practice for Health Promotion in Higher Education Effective practice of health promotion in higher education requires practitioners to understand apply 4. professionally recognized and tested theoretical approaches that address individual and community health. 5. evidence-based approaches to health promotion. 10

Transtheoretical Model of Individual Change Use stage matched messages to move to “Action” 11

Transtheoretical Model of Organizational Change 12

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

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

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

Reasons Why Leaders are Not Supportive of Health Promotion ¢ ¢ ¢ 16 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.

Historical Snapshot Corporate & College Health Promotion 1 st Generation Recreation 1850 s 2 nd Generation Fitness 1970 s 1 st Generation Instruction, Treatment, Exercise 17 3 rd Generation 4 th Generation Health Promotion 1980 s HPM ~1995 2 nd Generation 2010 3 rd Generation Health Education > Promotion HAPM

Reasons Why Leaders are Not Supportive of Health Promotion ¢ ¢ ¢ 18 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.

“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. ” Mc. Ginnis, 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. 19

Broad Picture of Health Essential Functions Critical to Campus Health 1. Prevent epidemics & injuries 2. Protecting against environmental hazards 3. Respond to disasters 4. Population-focused health promotion creating environments for healthy behaviors 5. Access to quality health care 20 Physical Mental

Reasons Why Leaders are Not Supportive of Health Promotion ¢ ¢ ¢ 21 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.

A Governor's Transformation ¢ e W n a c t n e v e r p ! s i h t June 2003 l l l l ¢ “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 l l Draining state treasury Weakening the economy 22

Personal Importance & Urgency Low Urgency Preparation, Action & Maintenance High Importance Low Importance 23 High Urgency Precontemplative & Contemplative

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

Reasons Why Leaders are Not Supportive of Health Promotion ¢ ¢ ¢ 25 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.

Healthy Campus 2010 Top 10 Health Impediments to Learning 26

Comparisons to Business Bank One 27

Comparisons to Business Bank One 28

Healthy Campus 2010 Receipt of Information from IHE 29

Healthy Campus 2010 Top 10 Physical & Mental Health Problems 30

Activity ¢ 31 Pros & Cons of Healthy Campus Initiative

Reasons Why Leaders are Not Supportive of Health Promotion ¢ ¢ ¢ 32 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.

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

Healthy Campus 2010: Health Impediment to Learning Stress 34

Visualize a Healthier Campus by Using the Targets ¢ Use of Ecological approach includes l ¢ Mandatory general education courses • personal health & consumer • stress management courses l l l 35 Social marketing College / school / group targeted interventions Policies Achieve Healthy Campus 2010 “Stress” objective target of 25% (from a baseline of 28. 4%) l 340 fewer students receiving lower grade or dropping classes • 2, 500 instead of 2, 840 l 12% reduction NOTE: for campus with 10, 000 students

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

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

Healthy Campus 2010 Health Impediment to Learning Cold/Flu/Sore Throat 38

Healthy Campus 2010: Health Impediment to Learning Alcohol Use 39

Visualize a Healthier Campus by Using the Targets ¢ Achieve Healthy Campus 2010 “Cold / flu / sore throat” objective target of 12% (from a baseline of 21%) l 1000 fewer students receiving lower grade or dropping classes • 1, 200 instead of 2, 200 l 40 45% reduction ¢ Achieve Healthy Campus 2010 “Alcohol” objective target of 2. 5% (from a baseline of 8%) l 550 fewer students receiving lower grade or dropping classes • 250 instead of 800 l 69% reduction NOTE: for campus with 10, 000 students

Activity ¢ 41 Ecologic Assessment

Resources ¢ ¢ ¢ 42 Institute for Health and Productivity Management l www. ihpm. org Academy of Health and Productivity Management l www. ahpm. org Wellness Council of America l www. welcoa. org Health Behavior and Health Education: Theory, Research and Practice l Karen Glanz, Barbara Rimer, Frances Lewis This Power. Point l www. csupomona. edu/~jvgrizzell/hc 2010/acha 05 nho