A Governor's Transformation

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A Governor's Transformation

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A Governor's Transformation 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

Wecan

prevent

this!

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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.“

A Governor's Transformation

“He's hoping to come up with financial and other incentives to change that.”

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"I didn't go on a diet as much as I changed a bad lifestyle. You can do it too!“

Governor Mike Huckabee

“We have reacheda point in time that wesimply have to start toaddress behavioralissues when we talkabout the general healthand well-being of anygroup of people.”

★ Increased productivity by 2 to 52 percentwww.arkansas.gov/ha/pdf/community_brochure.pdf

Healthy Arkansas

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Helping Policymakers Discover the Health and Productivity Academic Performance Connection

Health & Productivity Management (HPM) Health & Academic Performance Management

(HAPM)

Jim Grizzell, MBA, MA, CHESCal Poly Pomona and Loma Linda University

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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

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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.

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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/

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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/

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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

4. professionally recognized and tested theoretical approaches that address individual and community health.

5. evidence-based approaches to health promotion.

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Transtheoretical Modelof Individual Change

Use stage matchedmessages to move to “Action”

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Transtheoretical Modelof Organizational Change

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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

http://www2.edc.org/cchs/

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Stages of Change Descriptions and Tasks 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

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Pros & Cons of Change and Stages of Changes

70% 22% 7% 1%

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of a “health agenda.” Do not understand the personal relevance of




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Historical SnapshotCorporate & College Health Promotion

1850s 1970s 1980s ~1995 2010

Recreation Fitness Health Promotion HPM

1st Generation 2nd Generation 3rd Generation 4th Generation

Instruction, Treatment, Exercise Health Education > Promotion HAPM

1st Generation 2nd Generation 3rd Generation

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good health in their own lives and Don’t believe there is a strong relationship



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“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.

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Broad Picture of Health

Essential Functions Criticalto Campus Health Physical Mental

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

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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



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A Governor's Transformation 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

Wecan

prevent

this!

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Personal Importance & Urgency

LowUrgency

HighUrgency

HighImportance

Preparation, Action &

Maintenance

LowImportance

Precontemplative & Contemplative

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Activity

Health and Productivity Connection QuestionnaireDeveloped by Molly McCauley, RN,

MPH, CHESDirector AT&T Health PromotionPast President Society for Public

Health Education (SOPHE) Work Well Health Assessment

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Healthy Campus 2010Top 10 Health Impediments to Learning

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21 20

16 15

119 8 8 7

25

12

16

12 12

7.56 6

2.56

0

5

10

15

20

25

30

Stress

Cold/flu

/sore

throat

Sleep diff

icultie

s

Concer

n for t

roubled

family

mem

ber...

Relatio

nship difficu

lties

Depres

sion

Inter

net Use/

Computer

Gam

es

Death of

family

mem

ber or

frien

d

Alcohol

use

Sinus infec

tion

2000 Baselines2010 Targets

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Comparisons to BusinessBank One

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Comparisons to BusinessBank One

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Healthy Campus 2010Receipt of Information from IHE

4843 42

40

33 3329

2219

14 12

55 55 55 55 55 55 55 55 55 55 55

0

10

20

30

40

50

60

AOD use prev

entio

n

Sexua

l assa

ult / R

leatio

nship viol

ence

STD preven

tion

HIV &

AID

S preven

tion

Physica

l acti

viti &

fitness

Dietar

y beh

avior

s & nutri

tion

Pregnan

cy prev

entio

n

Tobac

co use

preve

ntion

Violen

ce prev

entio

n

Injury

preve

ntion &

safet

y

Suicide p

reven

tion


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Healthy Campus 2010Top 10 Physical & Mental Health Problems

4441

25

1614

10 107 6 6

3937

1113

86 6

4 4 4

05

101520253035404550

Back Pain

Allergi

es

Sinus Infec

tion

Depres

sion

Strep Thro

at

Ear In

fectio

n

Asthma

Bronch

itis

Anxiety

Repeti

tive S

tress

Inj


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Activity

Pros & Cons of Healthy Campus Initiative

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good health in their own lives. Don’t believe there is a strong relationship



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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

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Healthy Campus 2010: Health Impediment to Learning

Stress

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Visualize a Healthier Campus by Using the Targets 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” objective target 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

NOTE: for campus with 10,000 students

http://www2.edc.org/cchs/

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Ecological Approach

Environmental Influences

Behavior settings: Rituals,student organizationsCultural Influences: Customs, traditions, valuesEconomic Forces: Student financial stability, budgetInhabitants: Diversity, Athletics,Greek, campus communities, etc.

Location of the campusWeatherConstructed designs, the “builtenvironment”Landscapes

Organizational StructurePoliciesOrganizational climate

Political climateConservative/liberal Pro education?Reinforcement and rewardsfor healthy org & indiv behaviors

Place People

Organization Community

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Stress Objective Environmental Influences

Financial concernsISO – global troubles

Relationships w/friendsLack of friends/commuters

Irresponsible drinkersUninvolved students

Warm climateLack of parking

High trafficCampus size—distances

Crowding—long lines

Services--lack of info Depts disconnected

Too many stepsWeak policy enforcement

Inconsistent messages

State budget crisisIncrease in tuition/fees

Rewards for over commitment

Culture of stress

Place People

Institution Community

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Healthy Campus 2010 Health Impediment to Learning

Cold/Flu/Sore Throat

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Healthy Campus 2010: Health Impediment to Learning

Alcohol Use

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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%) 1000 fewer students


• 1,200 instead of 2,200

45% reduction

Achieve Healthy Campus 2010 “Alcohol” objective target of 2.5% (from a baseline of 8%) 550 fewer students


• 250 instead of 800 69% reduction

NOTE: for campus with 10,000 students

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Activity

Ecologic Assessment

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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

http://www.ihpm.org/

http://www.ahpm.org/

http://www.welcoa.org/

http://www.csupomona.edu/~jvgrizzell/hc2010/acha05nho

Documents

A Governor's Transformation