STUDENT HEALTH SERVICES Moving from a Traditional Medical Model to a New Era of Health and Wellness:

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STUDENT HEALTH SERVICESMoving from a Traditional
Medical Modelto a New Era of Health and
Wellness a Wellness Concept
Jim Grizzell, MBA, MA, CHES, HFI, FACHA
May, 2007
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NOTE
There are a few too many concepts covered in
these 36 slides for one session. Additionally,
the information presented may need to be tailored
to each SHS department with not only big picture
campus specific NCHA and other assessment data
but department specific data. Slides 2 and 3 are
BLUF slides (bottom line up front) telling the
problem and recommended solution. National data
is used. Campus data, ideally, will be used for
your campus. Slide 4 has the table of contents.
Each of the four sections could be covered in its
own 15 to 30 minute training session with SHS
staff. Sections include visualizing a healthy
campus, understanding the health continuum,
making an academic and business case for health
and wellness to include cost effective,
evidence-based and high reach / low cost
practices, and, finally, best practice tools.
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ProblemNationally, Student Health is Worse

• Most of the top 20 health problems and
  impediments to student learning are worse (see
  notes section)
• Average 19, Range 10 - 79

NCHA data N 17,000 to 46,000/yr, HIAP
Health Impediment to Academic Performance
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SolutionHealth Agenda and Wellness Concept

• Determine priority health problems
• Conduct market research on target audiences
• Develop student learning outcomes
• Set measurable objectives
• Develop Health Agenda / Wellness Concept programs
  and services by combining
• Evidence-based medical care and evidence-based
  health education
• Intervention Pyramid and Health Continuum
  approaches
• Implement programs
• Monitor, evaluate, close the loop

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Moving to a New Era of Health Wellness

• Visualize a healthy campus
• Think health agenda and Wellness Concept
• Instead of healthcare agenda and traditional
  medicine
• Health continuum
• Disease ? optimal health
• Clinical care ? health promotion
• Tertiary ? primary prevention
• Business case for health and wellness
• Health academic performance management
• Cost effective, evidence-based, high reach / low
  cost
• Use best practice guidelines
• AAAHC, ACHA, CAS, NASPA, CDC

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Visualize a Healthy CampusDecide What It Could
Look Like

• Use BHAGs, Vision, Mission, Goals, Objectives
• Know health status behaviors
• Wellness Wheel
• AAAHC
• Health behaviors students want to improve
• Physical and mental health problems
• Receipt of information on health topics
• Health impediments to academic performance
• CAS student learning outcomes

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Visualize a Healthy CampusWellness Wheel Topics
Social
Spiritual
Physical
Mental/ Emotional
Cultural
Occupational
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Visualize a Healthy CampusAAAHC Topics
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Visualize a Healthy CampusHealth Behaviors
Students Want to Improve
www.csupomona.edu/jis/1998/brown.pdf
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Visualize a Healthy CampusReceived Information
in Last Year
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Visualize a Healthy CampusReceived Information
in Last Year
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Visualize a Healthy CampusHealth Problems in the
Last Year
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Visualize a Healthy CampusMental Health in Last
Year
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Visualize a Healthy CampusSeriously Considered
Suicide in Last Year
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Visualize a Healthy CampusHealth Impediments to
Academic Performance
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Visualize a Healthy CampusCAS Student Learning
Outcomes

• Make objectives for your programs to have
  outcomes that students
• Choose behaviors and environments that promote
  health and reduce risk
• Articulate the relationship between health and
  accomplishing life long goals
• Comprehend the continuum between illness and
  wellness
• Exhibit behaviors that advance a healthy community

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Think Health AgendaNew Era of Health and Wellness
Traditional Medical Model
21st Century Health Promotion
Wellness Concept
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Think Health AgendaNew Era of Health and Wellness
Traditional Medical Model
21st Century Health Promotion
Wellness Concept
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Think Health AgendaHealth Continuum
Disability Signs
Attitudes Symptoms Knowledge Health Promotion
Premature Death
Optimal Health
Traditional Health Education
21st Century Health Wellness Wellness Concept
Traditional Medicine
Neutral Point No discernable illness or wellness
Illness
Wellness
Adapted from O'Donnell, Michael, DrPH, MBA, MPH.
"Definition of Health Promotion." American
Journal of Health Promotion. Summer 1986, Vol.1,
No. 1. p. 4.
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Think Health AgendaStudy Well Health Continuum
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Historical Snapshot Think Health Agenda
Business Case Corporate College Health
Wellness
1st Generation 2nd Generation 3rd
Generation 4th Generation
Recreation Fitness Health
Promotion HPM
1850s 1970s
1980s 1995
2010
1st Generation
2nd Generation
3rd Generation
Instruction, Treatment, Exercise Health
Education gt Promotion HAPM
Health Productivity Management, Health
Academic Performance Management
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Business CaseEvolution of Health Wellness
Traditional Medical and Health Promotion
Traditional Medical Model and Health Education
Health and Academic Performance Management
Name of Model
Fun activity focus No risk reduction No high risk
focus Not HCM oriented All voluntary Site-based
only No personalization Minimal incentives No
sig. others served No assessment/eval
Add focus on student learning Strong risk
reduction Strong high risk focus Some required
activity Site and virtual Strongly personal
(individual, group) Major incentives Sig. others
served Rigorous assess/eval
Mostly health focus Some risk reduction Little
risk reduction Limited HCM oriented All
voluntary Site-based only Weak personalization Mod
est incentives Few sig. others served Weak
assess/eval
Main Features
Activity Oriented
Morale Oriented
Results / Outcome Oriented
Primary Focus
Health Cost Management, NOTE chart adapted
from Chapman, see notes section for reference.
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Business Case - Intervention Pyramid21st Century
Health and Wellness
Low
High
Specialty Care
Cost
Reach
Primary Care
Activities no feedback Health Systems Activities
w/ Health Education
Community Neighborhood Collaboration
Health Communication Social Marketing
Policies
High
Low
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Business CaseLevels of Interventions Wellness
Program ROIs
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Business CasePopulation-Based vs Traditional
Intervention ROIs

• Population-Based Environmental Support
• Social Marketing Mass Media Campaign
• 294 x 4,500 1,323,000
• ROI 4.41 (cost is less than benefit)
• Traditional Willing Volunteer-Based Intervention
• Classes people voluntarily attend
• 294 x 250 73,500
• ROI 0.731 (cost is greater than benefit)
• Johnson Johnson health care costs avoided for
  each employee that gets regularly physically
  active
• WHEELING WALKS a media-based intervention to
  increase walking. Bill Reger-Nash, EdD,
  www.americawalks.org/PDF_PAPE/Reger.pdf

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Best PracticesHealth Services and Health
Promotion Standards
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Best PracticesACHA Tripod Tools
Organizational Development Standards
Professional Development Standards
Standardized, Valid, Reliable Measures for
Assessment and Evaluation
Strategic Planning for Aligning College Health
with National Health Objectives
www.surveymk.com/s.asp?u37043866952
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Best Practices 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

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Best Practices Social Marketing

• A process for influencing human behavior on a
  large scale, using marketing principles for the
  purpose of societal benefit rather than
  commercial profit.

William Smith, Academy for Educational Development
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SummaryMoving to a New Era of Health Wellness

• Visualize a healthy campus
• Think health agenda and Wellness Concept
• Instead of healthcare agenda and traditional
  medicine
• Health continuum
• Disease ? optimal health
• Clinical care ? health promotion
• Tertiary ? primary prevention
• Business case for health and wellness
• Health academic performance management
• Cost effective, evidence-based, high reach / low
  cost
• Use best practice guidelines
• AAAHC, ACHA, CAS, NASPA, CDC

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Questions?
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Why Move to a Wellness Concept?Increases for Top
11 Health Problems
2000 Baselines
HIAP Health Impediment to Academic Performance
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Fight 21st century health problems with 21st
century tactics. Dont remained mired in 20th
century tactics.
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Evolution of Health Promotion
Health Cost Management
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Sequence of Critical Success Factors
Positive Outcomes
Increased student learning Reduced
health care costs Risk reduction
(students with fewer risks)
Improved attitudes behaviors
Teams Participation (80 of
students) Commitment (set
organization individual goals)
Awareness (HRAs, Group Individual Reports,
80 of students) Increased knowledge
(educate faculty, staff and students)
Teams and Program Coordinators Senior Management
Support
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Processes of Change
Positive outcomes and ROI Reduced
utilization Reinforcement Management
Finding intrinsic and extrinsic rewards
for new ways of working Environmental
Reevaluation Appreciating that the
change will have a positive impact on the
learning environment Self-Liberation
Believing that a change can succeed and making
a firm commitment to the change Self-Reevaluatio
n Appreciating that the change is important to
ones identity, happiness, and
success Dramatic Relief Emotional arousal, such
as fear about failures to change and inspiration
for successful change Consciousness Raising
Becoming more aware of a problem and potential
solutions