Healthy Campus 2020 Focus on Determinants of Health

Healthy Campus 2020 Focus on Determinants of Health and Evidence-Based Actions Jim Grizzell, MBA, MA, CHES, ACSM-HFS, Cal Poly Pomona; Karen Moses, MS, RD, CHES, Arizona State University Michelle Burcin, Ph. D, MPH, CHES, University of South Carolina; Cynthia Burwell, Ed. D, CHES, Norfolk State University

Learning Outcomes Explain determinants of health and action model Define evidence-based public health Describe how to use the Healthy People 2020 online database of evidence-based actions and strategies 2 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Agenda Who’s leading the Healthy People initiative? Rationale for using social determinants of health and evidence-based actions What are social determinants of health? Steps that can be taken by Healthy People 2020 users NASPA’s campus ecology model What is evidence-based public health? Strategies to broaden the evidence-base for public health For higher education: resources for identifying evidence- based actions Resources and References 3 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

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Vice-Chairs and Members Healthy People 2020 Advisory Committee Jonathan E. Fielding, MD, MPH, MA, MBA Director and Public Health Officer Los Angeles County, Department of Public Health Professor of Health Services and Pediatrics and Co-Director UCLA Center for Healthier Children, Families and Communities Shiriki K. Kumanyika, Ph. D, M. P. H. Professor of Biostatistics and Epidemiology Department: Biostatistics and Epidemiology University of Pennsylvania School of Medicine, Center for Clinical Epidemiology and biostatistics William Douglas Evans, Ph. D; Vincent Felitti, MD; Everold Hosein, Ph. D; Lisa Iezzoni, MD, MSc; Abby King, Ph. D; Ronald Manderscheid, Ph. D; David Owen Meltzer, MD, Ph. D; Eva Moya, LMSW; Patrick Remington, MD, MPH; David Siegel, MD, MPH; Adewale Troutman, MD, MPH 5 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Rationale for SDOH and EB Actions Past Healthy People documents Catalogues of burden of ill-health, disability and premature death Set of targets for reducing burden What was missing? Guidance on potential actions for achieving targets Relative effectiveness of actions Advisory Committee recommendation Tie goals and objectives to evidence-based interventions that guide effective action and accountability 6 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Overarching Goals of Healthy People 2020 Address the factors that contribute to our collective health and illness by calling for healthy places & supportive public policies placing emphasis on the determinants of health Reflect Advisory Committee recommendations Redirect our attention from health care to health determinants “Health determinants should be a primary focus of Healthy People 2020: health care, a secondary focus. ” Phase 1 Report: Recommendations for the Framework and Format of Healthy People 2020, October 28, 2008. Page 20. 7 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Healthy Campus 2020 Overarching Goals Create social and physical environments that 8 promote health, safety and learning Supports efforts to increase academic success, student retention and life long learning Eliminate preventable disease, disability, injury, and premature death Achieve health equity, eliminate disparities, and improve the health of the entire campus community Promote healthy development and health behaviors across every stage of life Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Healthy Campus 2020 Mission Identify nationwide health improvement priorities in higher education Increase awareness and understanding of determinants of health, disease, and disability and the opportunities for progress Provide measurable objectives and goals that can be used at institutions of higher education Engage multiple constituents to take actions to strengthen policies, improve practices, and empower behavior change that are driven by the best available evidence and knowledge Identify and promote relevant assessment, research and data collection needs 9 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

From Sept 17 -18, 2009 meeting slides 10 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

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Social-Ecological Models Over the life span IOM model of multiple determinants of health used to develop Action Model for Healthy People 2020. Dahlgren, G. (1995) European Health Policy Conference: Opportunities for the Future. Vol. 11 – Intersectoral Action for Health. Copenhagen: WHO Regional Office for Europe 18 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

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NOTE * Evidence-based, HIA positive health impacts, ROI >1: 1 20 ** SMART: Specific, measurable, achievable, relevant, time-specific Healthy Campus 2020: Determinants of Health and Evidence-Based Actions NOTE: added planning model & learning & playing conditions

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World Health Organization Ottawa Charter Healthy settings, cities, worksites, schools “We shape our [campuses]; thereafter, they shape us. ” - Winston Churchill 25 Think Health Agenda and Healthy Settings to Enhance Health & Learning

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Social-Ecological Models 27 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

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 This section presented by Karen Moses 28 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

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 29 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Influencing Factors Characteristics of the: Individual Community Place Organization 30 People Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Environmental Influences Place The location of the campus The weather The constructed designs Landscapes Organizational Structure Policies Organizational Climate 31 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 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Stress: Environmental Influences Place People Financial concerns Warm climate ISO – global troubles Lack of parking Relationships w/friends High traffic Lack of friends/commuters Campus size—distances Irresponsible drinkers Crowding—long lines Uninvolved students Institution Community State budget crisis Services--lack of info Increase in tuition/fees Depts disconnected Rewards for over Too many steps commitment Weak policy enforcement Culture of stress Inconsistent messages 32 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

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 33 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Evidence-Based Public Health Actions Origins of movement to EBPH, roots in EBM Prior to 1970 s: “Uninformed intuition, unsystematic clinical experience, . . . ”* 1984: US Preventive Services Task Force EBPH “is the development, implementation, and evaluation of effective programs and polices in public health through application of principles of scientific reasoning, including systematic uses of data and information systems, and appropriate use of behavioral science theory and program planning models. ” 34 * Hill, E. , Alpi, Auerbach, of. M. , Evidence-based practice in health education and Healthy Campus 2020: K. , Determinants Health and Evidence-Based Actions promotion: a review and introduction to resources. Health Promot Pract 2010; 11; 358

Evidence-Based Public Health Actions Categories of social decision making 1. 2. 3. Independent of context Context sensitive Anecdotal Assessing interventions 1. Systematic reviews 2. Health impact assessments (HIAs) 35 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Sources for Evidence-Based Actions NIAAA www. niaaa. nih. gov Higher Education Center for www. highereducationcenter. org s www. samhsa. gov/ebpwebguide/index. asp Guide to www. thecommunityguide. org/index. html 36 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Sources for Evidence-Based Actions http: //www. nrepp. samhsa. gov Higher Education Center for Adrug www. higheredcenter. org/prevention/strategic-planning Strategic Planning CDCynergy Social M Strategic & Intervention Planning www. orau. gov/cdcynergy/soc 2 web/Content/phase 01. htm 37 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Tags for Use in Database Queries Settings Government Roles Private Healthy People health/healthcare sector Education Workplaces Communities Institutional settings Regional/national Organizations 38 Users Objectives Target Population Selection criteria Approving body Examples and resources Key words Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Click on image to go to web site www. nrepp. samhsa. gov/find. asp 39 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions

Summary & Questions Who’s leading the Healthy People initiative? Rationale for using social determinants of health and evidencebased actions What are social determinants of health? Steps that can be taken by Healthy People 2020 users NASPA’s campus ecology model What is evidence-based public health? Strategies to broaden the evidence 40 base for public health Healthy Campus 2020: Determinants of Health and Evidence-Based Actions For higher education: resources for

Resources Links to this presentation and reference files www. csupomona. edu/~jvgrizzell/hc 2020/acha 2010 presentations. htm Presenters Jim Grizzell, MBA, MA, CHES, ACSM-HFC Karen Moses, MS, RD, CHES California State Polytechnic Arizona State University, Pomona jvgrizzell@csupomona. edu (909) 856 -3350 karen. moses@asu. edu Cynthia Burwell, Ed. D, CHES (480) 965 -1360 Michelle Burcin, Ph. D, MPH, CHES University of South Carolina Norfolk State University mburcin@mailbox. sc. edu cburwell@nsu. edu (803) 777 -4752 (757) 823 -9494 41 Healthy Campus 2020: Determinants of Health and Evidence-Based Actions