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Creating a Culture of Wellness: A Call to Action for Higher Education, Igniting Change in Academic Institutions

  • Franklin University


Background: Due to the continued rise of chronic conditions and unhealthy lifestyle choices, more innovative and evidence-based practices are needed for students, faculty and staff to improve population health outcomes and enhance overall well-being. Aim: The purpose of this paper is to inform academic health promotion professionals of key strategies to consider in order to create cultures of wellness on their college campuses. Methods: A review of the existing literature was conducted. Results: The most current evidence-based practices to create a culture of wellness are discussed. Conclusions:Institutions of higher education have an opportunity to create campus cultures that foster health and well-being. The time is now for enacting change to create, improve, or sustain cultures of wellness within campus communities.
Building Healthy Academic Communities Journal Vol. 3, No. 2, 2019
2019 Amaya, Donegan, Conner, Edwards, & Gipson. This article is published under a Creative Commons Attribution-
NonCommercial-NoDerivatives 4.0 International License (
Creating a Culture of Wellness: A Call to Action for Higher Education,
Igniting Change in Academic Institutions
Megan Amaya, PhD, CHES
The Ohio State University
Teresa Donegan, PhD
TDonegan Consulting, LLC
Debbie Conner, PhD, MSN, ANP/FNP-BC, FAANP
Franklin University
Julie Edwards, MHA
The University of Chicago
Christy Gipson, PhD, RN, CNE
The University of Texas at Tyler
Background: Due to the continued rise of chronic conditions and unhealthy lifestyle choices, more
innovative and evidence-based practices are needed for students, faculty and staff to improve population
health outcomes and enhance overall well-being.
Aim: The purpose of this paper is to inform academic health promotion professionals of key strategies
to consider in order to create cultures of wellness on their college campuses.
Methods: A review of the existing literature was conducted.
Results: The most current evidence-based practices to create a culture of wellness are discussed.
Conclusions: Institutions of higher education have an opportunity to create campus cultures that foster
health and well-being. The time is now for enacting change to create, improve, or sustain cultures of
wellness within campus communities.
Submitted 4 September 2019: accepted 27 September 2019
Keywords: culture of wellness, universities, health promotion, well-being
We are currently at a critical moment in the health and wellness of Americans. Six in ten adults in the United States
have a chronic disease; four in ten have two or more (Centers for Disease Control and Prevention [CDC], 2019).
Obesity has surpassed tobacco as the number one cause of preventable death and disease in the United States
(Cleveland Clinic, 2017). The rate of mental health conditions is increasing among college students, with top diagnoses
being anxiety, depression and panic attacks (Oswalt et al., 2018).
Suicide is now the second leading cause of death in
the United States among college students (CDC, 2017). Suicide rates have increased by 30% in nearly every state from
1999 through 2016 (CDC, 2019). Conversely, seventy-five percent of chronic conditions are preventable. Key lifestyle
Building Healthy Academic Communities Journal Vol. 3, No. 2, 2019
risks include tobacco use, unhealthy food choices and portion control, inactivity, excessive alcohol use and unmanaged
stress (CDC, 2019).
In the field of worksite health promotion, historically, corporations have been the leaders in instituting workplace
wellness programs. One of the aims of such programs is to reduce health care costs (Kent, Goetzel, Roemer, Prasad,
& Freundlich, 2016). Employers have also become increasingly more interested in other benefits of wellness
programs, including employee recruitment, retention, work engagement, productivity and business outcomes, such as
customer satisfaction. Based on recent Gallup data (Gallup, 2018), only 34% of American workers are engaged in
their work. In other words, a minority of employees are passionate about what they do. Fifty-three percent are slightly
or not engaged, and 13% are actively disengaged, acting out their dissatisfaction at the workplace (Harter, 2018). In
the corporate world, employers with their focus on innovation and progress rely on the talent of their employees to
think critically and originally to solve problems and create solutions. Lack of engagement can cripple an organization’s
ability to grow and thrive.
At the inaugural Building Healthy Academic Communities National Summit April 2013, renowned keynote
speaker from the Johnson & Johnson’s Human Performance Institute, Jack Groppel, PhD, presented a new paradigm
that linked work performance to level of engagement (Groppel, 2013). Groppel suggested underutilized human assets
can lead to tens or hundreds of millions of dollars in lost productivity. Lack of engagement can lead to high turnover
rates. Organizations may try to improve performance by offering training and professional development
opportunities; however, increasing work demands and rapid technological and social changes result in employee stress
and take a toll on their personal lives (Groppel, 2016).
In large part, throughout the history of academic institutional wellness programming, wellness programs have typically
been geared for the student population. Most institutions and executive administrators are challenged with sustaining
themselves financially, by remaining competitive in the marketplace, and attracting and retaining students. Executive
leadership, faculty and staff are becoming more aware of the impediments that undermine student success metrics,
like sleeplessness, anxiety, stress, depression, poor eating habits, lack of activity and overall poor coping mechanisms
(American College Health Association, 2018). Although many academic institutions have instituted wellness programs
for students and/or employees, there are a limited number who have implemented comprehensive, structured and
integrated approaches to health and wellness (Hill-Mey et al., 2015). At the 2015 International Conference on Health
Promoting Universities and Colleges, the Okanagan Charter (2015), an international organization based in Canada,
presented a "transformative vision for health promoting universities and colleges.” The Charter provides a rationale
for the need to develop cultures of wellness at universities, positing that higher education plays a central role in all
aspects of the development of individuals, communities, societies and cultures – locally and globally. Academic
institutions have a unique opportunity and responsibility to provide transformative education, engage the student
voice, develop new knowledge and understanding, lead by example, and advocate to decision-makers for the benefit
of society. In the emergent knowledge society, higher education institutions are positioned to generate, share and
implement knowledge and research findings to enhance the health of citizens and communities both now and in the
future. The sheer volume of people who live, work and visit academic institutions can allow for a greater collective
impact, with work done collaboratively in transdisciplinary and cross-sector ways. Higher education institutions can
Building Healthy Academic Communities Journal Vol. 3, No. 2, 2019
incorporate health promotion values and principles into their mission, vision and strategic plans, and model and test
approaches for the wider community and society. While the charter provides a framework for embedding health into
all aspects of campus culture, it does not yet provide specific examples of what has been successful in creating a
culture of wellness at academic institutions.
As of 2016, fifty-seven percent of colleges and universities reported offering an employee wellness program
(College and University Professional Association for Human Resources, 2017). Published research (Madison, 2016;
Jones, Molitor, & Reif, 2018; Song & Baicker, 2019) on the subject have touted wellness programs as ways to enhance
morale, boost productivity, reduce turnover, lower healthcare costs, and improve overall population health (Health
Enhancement Research Organization, 2015). In 2015, in a study conducted by Harrill, Lawton, and Fabianke, the
investigators found that the core component of student success was based on faculty and staff engagement. The study
results recognized that the key to successful, sustainable and impactful organizational and cultural change hinged on
faculty and staff. They should not only be engaged but should lead or “drive” the work (Harrill, Lawton, & Fabianke,
According to Gallup (Marken & Matson, 2019), faculty and staff who are emotionally and psychologically engaged
are more committed to their work and produce better student outcomes than less-engaged peers. Based on their
research, only 34% of faculty and staff within higher education are engaged at work, which is lower than those in
industry settings. Challenges include over ambitiousness and hastiness in taking on too many initiatives at one time,
poor project planning, or taking on projects that do not fit the needs and culture of the institution. Top-down
leadership can also lead faculty and staff to feel that their input and expertise are not valued. Higher education needs
to continue to make the case for creating a culture of wellness that will benefit all of society, starting locally on our
college campuses, to improve population health and decrease fiscal strain on our healthcare system.
The National Consortium for Building Healthy Academic Communities was created to harness the brainpower
of academic institutions to address the impending healthcare crisis. When academic institutions take the lead in
creating best practices and standards in health and wellness, they support the health efforts of their own students,
faculty, and staff, as well as facilitate wellness in the surrounding community. The spirit of the Consortium is
collaborative in nature. One of its goals is to promote transdisciplinary wellness partnerships, education and initiatives
across academic institutions. Participating institutions can benefit from both sharing innovative initiatives and learning
from others' successes. This "call to action" paper is targeted at institutions that are in the initial discussion or strategic
planning phases of creating a culture of wellness, regardless of size or resources. The purpose of this paper is to
provide strategic guidance gleaned from lessons learned from the corporate sector as well as several academic
institutions that have fully implemented a comprehensive wellness initiative. The hope is to inspire change, while
considering that plans will have to be tailored to be both feasible and manageable.
When considering health and wellness initiatives, a good place to start is to identify how these elements have been
defined by corporate, academic and government entities. The prevailing nomenclature used across the U.S.,
particularly in healthcare and health promotion contexts, is a “culture of health.” The Robert Wood Johnson
Foundation (RWJF, 2019), an organization at the forefront of creating a culture of health from a broad community
perspective, identifies four action areas in their model: (1) making health a shared value; (2) fostering cross-sector
Building Healthy Academic Communities Journal Vol. 3, No. 2, 2019
collaboration to improve well-being; (3) creating healthier, more equitable communities; and 4) strengthening
integration of health services and systems. According to RWJF, a culture of health seeks healthier communities,
promotes the integration of systems to create healthier choices for all, now and for generations to come, and includes
shared values, and collaboration (RWJF, 2019).
Healthy Campus 2020, a component of the American College Health Association (ACHA, 2018), supports the
ecological model for all academic wellness programming. The social ecological theory considers the various contexts
that influence how individual choices are made including whether to adopt healthy behaviors and to participate in
wellness programming (Terrell, 2015). The ecological theory was created to move away from overemphasizing
individual choice in decision making around health behavior. When health promotion and disease prevention gained
interest in private, public and professional sectors in the late sixties, critics accused proponents of life-style
interventions of fostering victim-blaming ideology and neglecting the significance of social influences on health and
disease (McLeroy, Bibeau, Steckler, & Glanz, 1988). The ecological model focuses attention on both individual and
social environmental factors as targets for health promotion endeavors. The social ecological theory identifies five
levels of influence on behavior:
Intrapersonal: The individual’s own set of characteristics, such as knowledge, attitudes, behavior, self-concept,
Interpersonal: Formal and informal social network and support systems which can include, but is not limited
to, family, work groups, and friendship networks;
Institutional: Social institutions with organizational characteristics and formal and informal rules and
regulations for operation;
Community factors: Relationships among organizations, institutions and informal networks within defined
boundaries; and
Public policy: Local, state, and national laws and policies.
For example, assuming an employee is “motivated to participate (intrapersonal), with supportive co-workers, and has
a worksite which offers time off to participate (institutional), that worker will be more likely to participate than if only
one or two of these influences are present” (Linnan et al., 2001). Several organizations have included ecological theory
in their definitions of what constitutes a culture of health:
A workplace ecology in which the dynamic relationship between human beings and their work environment
nurtures personal and organizational values that support the achievement of a person's best self while
generating exceptional business performance (Pronk, 2010);
a workplace ecology that is intentionally designed with elements that support health and well-being (Health
Enhancement Research Organization [HERO], 2016);
and workplace wellness programs that involve “a coordinated, systematic and comprehensive set of strategies
which include health programs, policies, benefits, environmental supports and links to the surrounding
community designed to meet the health and safety needs of employees (CDC, 2016).”
In summary, an ecological model focuses on population- and individual- level determinants of health and
interventions. It acknowledges that health is influenced by an array of interdependent factors including community,
institutional, interpersonal, and intrapersonal components (ACHA, 2018).
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The World Health Organization (WHO) originally defined health as a “state of complete physical, mental, and
social wellness, and not merely the absence of disease or infirmity” and a fundamental human right without distinction
of race, religion, political belief, economic or social condition (WHO, 1946; WHO, 2006). Current definitions attempt
to embody a variety of components that contribute to health. The shift from “health” to “wellness” nomenclature
was derived to acknowledge that being healthy is no longer predicated on the physical dimension alone. The Substance
Abuse and Mental Health Services Administration (SAMHSA) suggested eight dimensions of wellness including
physical, intellectual, environmental, financial, occupational, social, emotional, and spiritual dimensions (SAMHSA,
When applied to wellness, health promotion practitioners need to consider how a program supports the individual,
impacts the population, aligns with health promoting policies, and has a positive influence on the organization’s
culture and environment. It must also synergize with the mission and goals of the organization.
There has been a small amount of evidence published on the topic of return on investment (ROI) and value on
investment (VOI). A study on ROI published by Goetzel et al. (2014), demonstrated a range of $2 - $10 return on
investment for every $1 spent on health and wellness. The settings for the research included private and corporate
organizations, so generalizability is limited; however, it provides important evidence for health promotion leaders as
they make the business case to top level leaders at their institutions. Value on investment is a more recent concept to
the field. VOI refers to a wider range of metrics including but not limited to: Engagement, productivity, resilience,
and the ability to attract and retain talent (employees and students). While it often pertains more to employee attributes
and experiences, it may also be applicable to student populations. The “student experience,” a metric of notable
consideration in the student services and higher education world, helps attract and retain students. High quality
student programming can include health and wellness opportunities to enhance the undergraduate and graduate
experience and improve academic performance (Ruthig, Marrone, Hladkyj, & Robinson-Epp, 2011). In addition,
students take those health-promoting skills and strategies with them into their professional and personal lives once
they graduate.
Kristen Madison (2016) offers an analysis and commentary in her article “The risks of using workplace wellness
programs to foster a culture of health.” She argues that employers, motivated by the potential for financial gains
related to health improvement may create substantial risks. She raises the following concerns: Employees may end up
shouldering more of the health costs, there is an increased possibility in employment discrimination, and finally there
is the potential for employers’ invasion of employees’ privacy. If faculty and staff perceive that their institution’s
primary motivation for introducing wellness initiatives is the bottom line, they may feel coerced into participating.
They may also worry that their employers are tapping into their personal health records through insurance claim data.
Goetzel, et al. (2017) responded to Dr. Madison’s commentary and agreed that there is a problem with single-
focused wellness programs that are based on the premise that incentivizing employees to improve their health is all
that is needed to create a healthy workforce. They argue that the actual problem however has to do with poor design
and believe that programs that focus solely on providing financial incentives for achieving targeted health outcomes
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can result in unintended consequences as mentioned above. The authors posit that workplace wellness programs that
are founded on a strong culture of health can influence employees’ health and well-being in a practical, ethical and
legal way. They further state that while it is the purview of employers to select which outcomes they focus on, research
has shown that the foundational difference between effective and ineffective programs is their intervention focus.
Finally, they noted that most companies are moving away from traditional ROI models to ones that value VOI metrics
and they believe it is “the right way to go” (Goetzel, et al., 2017).
A culture that promotes wellness requires an array of key components in order to flourish. These factors include but
are not limited to:
1) A systemic approach with a shared vision, mission and framework to guide strategy;
2) Leadership and management support, which includes verbally supportive messaging about why the institution
invests in wellness, role modeling healthy behaviors, and allowing for wellness activities to take place during
the workday;
3) Policies and procedures that support wellness. For example, a tobacco-free campus;
4) Access to outcomes data and evaluation of the culture, initiative and programming on a regular and consistent
5) Resource allocation and commitment, such as financial funding, dedicated staff and physical space/prompts;
6) Grassroots efforts and peer support, such as student and faculty/staff wellness champion teams;
7) Partnerships and collaborations between groups within and outside the institution to further the cause;
8) Practices that are based on evidence using well-defined metrics of success that also allow for innovation and
creativity to interweave when appropriate;
9) Effective communication about wellness opportunities and resources;
10) A sense of community in which people participate in programs and services;
11) Meaningful incentives that encourage participation; and
12) On-boarding and orientation to the initiative, along with annual training and learning opportunities;
13) Involving and obtaining feedback from students and/or faculty and staff in the design and implementation
of programs;
14) Rewards and recognition for students, faculty and staff;
15) A variety of options that appeal to different interests.
These important considerations and best practices should be included in any comprehensive and integrative
wellness initiative, addressing students and faculty/staff concerns. Understandably, not all institutions are to the point
where they can implement all of the strategies recommended above. The health promoting practitioner needs to
understand what elements can be implemented to create a culture of wellness and begin the process of discovering
and delivering what is appropriate for their current environment. A first step could be conducting a needs assessment
for all members of the institution’s community. Organizational wellness programs operate on a continuum and need
to start somewhere. Targeting practices that are most realistic and feasible to implement first, while working on the
potentially more challenging aspects over time, make sense logically and can prove to be winnable outcomes to help
pave the way for more advanced practices. It takes many years to change culture, to see notable VOI, and for certain
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practices to unfold. The “low hanging fruit,” however, can produce results in a more reasonable time frame.
Additionally, it will be key to measure and track progress for what is implemented. Accountability and quality
improvement will provide you the means to acquire additional resources and support.
This section briefly showcases several institutions of higher learning who are implementing a culture of wellness on
their college campuses. Each one uses a foundation and strategy to drive programming and engagement. They all
utilize multiple best practices noted previously. Although this is not an exhaustive list, it is encouraging that more and
more universities and colleges are adopting a framework that incorporates students, faculty and staff; and additionally
in most cases, visitors and guests to their college campuses.
Binghamton University’s Healthy Campus Initiative (HCI), B-Healthy, is based on an eight-dimension model
of wellness that supports the vital components of learning, living and working within a community whose vision is to
become a premier public university for innovation in campus and community health and well-being (J.M. Fioreconte,
personal communication, June 5, 2019). The HCI’s ecological approach illustrates the interconnectedness of the many
aspects of living and how, together, they contribute to a healthy existence and offer a multi-faceted view of the
connections between health, learning, productivity and campus structure. Population and individual action items and
objectives are data-driven and tied directly to the priorities of the university president’s Road Map to Premier strategic
plan. Collaborations with key partners and multiple constituents have proven to be fundamental in moving the HCI
Case Western Reserve University has utilized the culture of health guidelines established by the Wellness
Council of America (WELCOA) to develop their wellness program. The seven benchmarks of success include: (1)
capturing senior-level support; (2) creating cohesive wellness teams; (3) collecting data to drive health efforts; (4)
crafting an annual operating plan; (5) choosing appropriate interventions; (6) creating a supportive, health-promoting
environment; and, (7) measuring and evaluating program outcomes (Click, 2017). The initiative focuses on creating a
campus environment that supports the health and wellness of faculty and staff to maximize their quality of life and
productivity and to help control health care costs. An incentivized program is available to all benefits-eligible faculty
and staff. The program incorporates evidence-based strategies into all programs and services to maximize impact and
to facilitate lifestyle behavior changes within the population. A Wellness Champions network, workplace integration
strategies, and community-building efforts have been particularly effective in enhancing well-being on campus. Over
the past five years, increasing numbers of faculty and staff have participated in the worksite wellness program with
64% meeting the entry requirements in 2018. Data analysis and evaluation occurs regularly to monitor outcomes.
In 2017, the university launched a student wellness initiative. It includes a variety of programs to help foster well-
being within the student population. Each semester, both wellness teams collaborate to offer a comprehensive
program for all faculty, staff and students at the university. Keys to success within the programs include emphasis on
policy modifications and environmental change and support in addition to lifestyle behavior change programs, and
participation behavior change challenges. Utilizing a multi-pronged approach ensures full well-being integration for
those who work, study, and live on campus (E.R. Click, personal communication, June 12, 2019).
Duke created the “Duke Healthy Campus” in 2016 as part of the Healthy Campus 2020 Initiative that aims to
engage the Duke community to build a healthy organization where faculty, staff and students “thrive and feel valued.”
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(Healthy Duke, n.d.) Spearheaded by Chancellor Eugene Washington in 2016, he engaged leaders from across the
institution to see how they could harness the collective impact of people, programs and strategies to create a
framework for this process. They developed a strategy around five focus areas: Food and nutrition, mental and
emotional wellbeing, physical activity and movement, fulfillment and purpose, and environment and culture. Leaders
from across the Duke community are facilitating working groups for each of the five key focal areas with a goal of
fostering inclusiveness, connectivity and innovation that fosters the health and wellness of all in their community.
The initiative is overseen by a steering committee composed of the key leaders of the institution (i.e., Chancellor of
Health Affairs, Vice President of Administration, Vice President of Student Affairs, Chief Human Resources Officer
for Duke University Health System).
“Live for Life,” Duke’s employee wellness program, offers a variety of programs and services including health
assessments and education, smoking cessation programs, and fitness and nutrition activities. “Duwell” is Duke’s
student-centered initiative that helps students focus on their individual wellness by looking at the integration of many
facets (i.e., intellectual, environmental, mind-body, financial, identity, values, choices, spiritual) of their life through
wellness promotion and risk mitigation. Through the provision of a variety of wellness experiences they aim to help
students manage stress and reduce anxiety while emphasizing self-care. Their comprehensive education framework
addresses topics like sexual health, alcohol, tobacco and other drugs and how they impact student life to help students
identify risky behaviors as part of their risk mitigation strategy. All programs are geared toward fostering daily practices
of health and wellbeing (T. Szigethy, personal communication, June 11, 2019).
The Georgia Institute of Technology (Georgia Tech) acknowledges that it is a diverse and complex
environment that strives for high levels of achievement where our community members seek to balance the
personal and professional challenges that are a part of life (S. Connell, personal communication, June 12, 2019).
Georgia Tech believes wellbeing is an essential piece of the human condition. Wellbeing is the fluid state of
life satisfaction impacted by circumstances, environment, and culture. Georgia Tech prepares and equips its
community members with the fundamental tools and life skills to thrive. Health and wellbeing at Georgia Tech
(HW@GT) unites Campus Recreation, Counseling Center, Health Initiatives, Stamps Health Services and the
newest department CARE, the Center for Assessment, Referral and Education, cultivate a culture of health,
wellbeing, and resilience through promoting and delivering programs, services, and experiences with
compassion and strategic collaboration. Under joint leadership from the Division of Student Life and Division
of Campus Services, HW@GT envisions students, faculty, and staff will lead balanced, connected, and
purposeful lives where they experience high levels of physical, emotional, social, and professional wellbeing.
Illinois State University has been creating a culture of wellness since 1984 when President Lloyd Watkins
established the Faculty Staff Wellness Initiative (N. Brauer, personal communication, June 20, 2019). Implemented
under the guidance of an interdisciplinary Wellness Committee, the team applied best practices from the beginning.
Key drivers are the Wellness Ambassador Program and the creation of the Wellness Participation Policy allowing
employees up to 90 minutes per week to engage in health and well-being programs, events, and services, and a
partnership with the Academic Areas in what is known today as The School of Kinesiology and Recreation. After 35
years, these initiatives remain strong and steady.
In 2009, health promotion and wellness for faculty, staff and students were brought under one roof, as a stand-
alone department to further the mission of Advancing Wellness at All Levels. By addressing well-being at the
population level, engaging the entire campus community in the health promotion process became a reality. The work
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is built on the socio-ecological framework and the eight-dimension model. Evidence shows that collaborative work
is the heart of advancing well-being across a community and is practiced through diverse initiatives. In 2017, the
health and wellness Community of Practice was established in the Division of Student Affairs. Now reporting to the
Vice President for Student Affairs are Campus Recreation, Health Promotion and Wellness, Student Counseling
Services, and Student Health Services; they are charged with being an educational partner elevating well-being for all
who live, learn, and work at Illinois State. The Community of Practice departments are involved in numerous
partnerships across campus and together they are involved and leading the Jed Campus Program, Exercise as Medicine
on Campus, the first cohort of the Culture of Respect Collective through NASPA, and in April 2019 joined the
Partnership for a Healthier America Healthy Campus program.
Commitment from the highest levels is demonstrated through the university strategic plan, Educate-Connect-
Elevate Illinois State, where goals committing to further community well-being are placed to strengthen and enable a
thriving body of students, staff, and faculty.
North Carolina State University has created a multifaceted wellness strategy which serves as the institution’s
approach for university wellness initiatives (Wolfpack Wellness, n.d.). It is derived from foundational frameworks of
the socioecological model of health promotion, common language from the Gallup-Purdue text Wellbeing and
concepts from Simon Sinek’s It Starts With Why. The model, referred to as “Build a Thriving Pack” examines people,
places and culture. The initiative includes (1) leadership support, (2) marketing and communications, (3) health
promotion policy, (4) built environment, (5) peer support, (6) built environment, (7) responsibility and (8) a sense of
The Ohio State University has a comprehensive and integrative approach to the One University Health and
Wellness initiative. Fostering a collaborative nature, the initiative is built upon the social-ecological framework and
nine dimensions of wellness. A wellness council, under the leadership of a university chief wellness officer, oversees
and directs strategic vision, including communication, leadership and management support, resource allocation, and
partnerships; and evaluates key program outcomes from a scorecard that measures wellness culture, population health
and fiscal spending. Robust, wellness champion teams exist for students and faculty/staff (Amaya, Melnyk,
Buffington, & Battista, 2017), and practices, resources, and programs are based on evidence.
The University of Utah (U of U) is establishing a culture of wellness using a collective impact approach with
multiple collaborative partners (R. Marcus, personal communication, June 17, 2019). The appointment of a Chief
Wellness Officer (CWO) for University of Utah Health in 2015 created opportunities for streamlining existing
wellness initiatives, and strategically aligning the creation of new programs. Comprehensive wellness services for
students continue to be offered across campus with the Campus Counseling Center, Student Life Center, Center for
Student Wellness, and Undergraduate Medical Education Wellness Program. A robust Graduate Medical Education
Wellness Program was established in 2016. Under the leadership of the CWO and with an interprofessional advisory
group, U of U Health launched the Resiliency Center in 2017 to promote faculty and staff wellness through
advocacy, collaboration and innovative programming focused on individual and system resilience. Under the
leadership of the CWO, Wellness and Integrative Health now offers faculty and staff Resiliency Center services
as well as fitness and nutrition services, the National Diabetes Prevention Program, Tobacco Cessation, and
Mindfulness Based Stress Reduction. With a grant from the American Cancer Society’s Tobacco Free
Generation Campus Initiative, the University became 100% tobacco free in 2018. University leadership support
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has been strong with the University joining the Partnership for a Healthier America’s Healthy Campus Initiative
in 2019 and the establishment of a campus-wide Wellness Committee.
Much of the published research for employee wellness program outcomes comes from industry, specifically the
corporate setting. Traditionally, academic institutions have lagged behind corporations for a host of reasons: Funding
constraints, state-run insurance programs, complex research processes, gaps in translational research, and transient
populations, particularly among students, which can be problematic for long-term follow-up. The American College
Health Association conducted a survey in 2014 to assess the current state of faculty and staff health and wellness
programs. In the survey, a question asking which resources would be most helpful for implementing employee
wellness programs was included, and 39% of respondents answered “best practices.” When asked about barriers to
program success, the top three barriers identified were cost of offering the program, lack of staff resources, and lack
of time of participants (Almeda, Brauer, Dewald, & Yingling, 2014). While more research and sharing of outcomes
and best practices is needed in settings of higher learning, health promotion professionals need to create solutions to
the multiple barriers inhibiting their ability to offer effective programming. Partnerships and collaborations can prove
to be very beneficial, bringing together teams and people across campus (e.g., facilities, transportation, human
resources, student wellness, health sciences colleges) who can help implement strategies and accomplish goals
It is clear that the need for effective change and action is warranted. First, universities must understand that every
person impacts the well-being of the campus community. Bringing together people representing all campus sectors
to share a common agenda and collaborate on wellness initiatives is crucial to effective change. By working together
to implement changes at the policy, institution, interpersonal and individual levels, collective impact can happen to
improve the well-being of students, staff and faculty. We urge universities to consider these strategies to improve or
sustain their culture of wellness. The time is now.
Building Healthy Academic Communities Journal Vol. 3, No. 2, 2019
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Author correspondence may be addressed to:
Megan Amaya, PhD, CHES
Assistant Professor
Ohio State University
1585 Neil Avenue
Columbus, Ohio 432190
Author’s Note and Acknowledgements
The authors would like to thank colleagues from the universities cited in the paper, for contributing a description of
their comprehensive wellness initiative at their respective university.
... Universities that consider 'students-as-partners' or co-creator [26][27][28] learn from students about their experiences to better understand how to accommodate them further [3,11] by creating a campus culture and environment that promotes "the culture of wellness" [29][30]. Considering the amount of time students spend in the university settings and the setting's potential impact on student mental health and wellbeing, holistic accounts derived from students are essential for understanding how to extend "compassion and care to students" [31, p.11] that will eventually result in an increased sense of belonging, student satisfaction, and retention. ...
... Furthermore, this study does not place blame on either side (students or universities) for why students as-a-whole are not reaching their full potential. Instead, the purpose of this article is to bring students' viewpoints to the forefront in order to initiate a conversation with other entities, which will aid in the future in the construction of a "culture of wellness" [29][30] for all. ...
Conference Paper
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In light of an emerging mental health crisis and the increasing diversity of the student body in undergraduate engineering education, this qualitative study explores student perceptions of university support regarding their wellbeing. We conducted focus groups with 16 undergraduate engineering students from a large R1 public minority-serving institution. Our participants largely perceived university personnel and resources as an insignificant source of support regarding their wellbeing. The findings on the lack of perceived support are organized by departmental and university-level influences. The students also identify areas for improvement that have posed barriers to their awareness and utilization of university supports and services and to their overall wellbeing. The method of soliciting student perspectives has implications for institutions wanting to examine their own practices and policies in order to better support students’ whole selves.
... We need to be given and to give ourselves permission not to be instantly available at all times. We need to learn to say 'no' to taking on just one more tutorial, one more research student, one more collaborative project, one more of the myriad requests that appear before us in ever cascading emails (Amaya et al. 2019). Overcommitting and over-working are not conducive to health and wellbeing. ...
The global pandemic of 2020 has changed the ways that university academics do their work and manage their time, including teaching , engaging with graduate students, conducting research, and working with colleagues. The mode of delivery of higher education has substantially moved to the digital, and workspaces have shifted to home. Having to work from home has placed unique demands on academics, including adapting to working entirely on ascreen and adjusting their work/life balance. Despite much anecdotal evidence that the well-being of academics is being adversely affected during this global pandemic, there is currently little published research about this issue. As five academics who work in an education faculty at an Australian university, we present our colla-borative autoethnographic reflections of this time. We share these experiences of being academics in 2020 through curated narrative vignettes, with analysis of the meaning of these vignettes. Employing aphenomenological approach, we craft understandings of our experiences and explore the immediate world of these experiences, constituted in our practices as academics and our personal lives in this challenging time of unexpected change. We note the phenomenon of feeling unsettled, distracted, overwhelmed and lacking focus, and being conflicted between various roles.
... As part of broader university-wide wellness initiatives, some college and university communities are providing online trainings, workshops, virtual meetups, and mental health resources to help faculty navigate both their personhood and professional self through these tumultuous times. Amaya et al. (2019) proposed a "call to action" for academic institutions to implement systemic initiatives that promote the health and well-being for all in the academic community: students, faculty, and staff. Given the COVID-19 pandemic, it is paramount for academic institutions to acknowledge the importance of faculty mental health as a central aspect of student engagement and success (Kennette & Lin, 2019). ...
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Background: With the global pandemic, higher education has experienced unparalleled changes with abrupt transitions to remote and online learning. Faculty are working to provide continuity of teaching and support to students whose lives have been disrupted; therefore, faculty are finding themselves managing distressed students with a wide range of issues, while also managing their own intrapersonal stress. Consequently, faculty may experience feelings of being psychologically overwhelmed and emotionally exhausted. Aim: This article informs faculty in higher education on the concept of compassion fatigue along with the symptoms, warning signs, and risk factors. In addition, protective factors, including self-care plans and coping strategies are addressed. Methods: A comprehensive review of the literature on compassion fatigue was conducted including the application of the construct to teaching and education. The literature review illuminates the use of compassion fatigue, originating from the scientific disciplines of counseling and traumatology, within an emerging line of research findings occurring amongst educators prior to the COVID-19 pandemic. Results: The literature demonstrates that compassion fatigue as a prospective, intrapersonal condition may potentially affect some faculty in higher education, and the proposed conceptual application of the construct to teaching and education can assist with acknowledging and understanding an important aspect of faculty mental health. Conclusions: Given the crisis surrounding the pandemic, it's essential for faculty to be aware of compassion fatigue in order to mitigate potential intrapersonal psychological and emotional consequences. Elucidating the symptoms and implications of compassion fatigue for faculty in higher education is part of a broader, overlooked issue on faculty mental health and wellness.
With gendered organization theory and n = 201 Historically Black Colleges and Universities women faculty, the following is addressed: RQ1 Which Historically Black Colleges and University women faculty, those at schools with or without an anti-bullying policy, are more likely to report workplace bullying? RQ2 What is the relationship between workplace bullying intensity and time spent strategizing against bullying, health problems, and organizational distrust for Historically Black Colleges and University women faculty? RQ3 How does workplace bullying affect the experiences of Historically Black Colleges and University women faculty? The mixed methods findings confirm the need for preventative structural changes policies to empower women.
Pressure to perform academically, financial stress, and accessibility of entering higher education institutions are common factors that impact the mental health of college students. Findings have suggested the mental health needs of college students worsened due to the COVID-19 pandemic. The purpose of this chapter is to provide a conceptualized mental health counseling perspective for promoting campus wellness with a growth-oriented philosophy that emphasizes how to support college students through SAMHSA's wellness model. The SAMHSA wellness model addresses eight domains: emotional, environmental, intellectual, occupational, physical, social, financial, and spiritual. Each domain will be explored with practical strategies for faculty and higher education leaders to implement across a campus setting.
Background Despite the public health significance of overweight and obesity, weight management has remained a low priority for health-related programming on university campuses. Objective Investigate the need for and feasibility of implementing university-based weight loss programs. Methods The Practical, Robust Implementation and Sustainability Model (PRISM) was used as a framework. Semi-structured individual interviews were conducted with fifteen university staff and students from two large U.S. universities in the Northeast and Mid-Atlantic. Interviews aimed to assess readiness, preferences, characteristics, barriers and facilitators in each of the four adapted PRISM domains: (1) Organizational and Recipient (Student) Perspectives on the Intervention, (2) Recipient (Student) Characteristics, (3) Internal Environment (organizational characteristics and infrastructure), and (4) External Environment. Verbatim transcriptions were analyzed using inductive and deductive thematic analyses. Themes were extracted as outlined by Consensual Qualitative Research. Results Participants supported university-based weight loss programs, but recognized barriers of resources, coordination across entities, and competing health issues taking priority for school programming. Campus built environment and students’ busy schedules were identified as barriers to maintaining healthy weight and participation in weight loss programs. Recommendations included designing weight loss programming with a positive and holistic approach, minimizing weight-stigma, ensuring support from university leaders and students, and securing external funding. Conclusions The identified themes provide recommendations for universities looking to develop and implement weight loss programming.
Purpose The purpose of this review article is to examine the well-being of faculty in higher education. Success in academia depends on productivity in research, teaching, and service to the university, and the workload model that excludes attention to the welfare of faculty members themselves contributes to stress and burnout. Importantly, student success and well-being is influenced largely by their faculty members, whose ability to inspire and lead depends on their own well-being. This review article underscores the importance of attending to the well-being of the people behind the productivity in higher education. Method This study is a narrative review of the literature about faculty well-being in higher education. The history of well-being in the workplace and academia, concepts of stress and well-being in higher education faculty, and evidence-based strategies to promote and cultivate faculty well-being were explored in the literature using electronic sources. Conclusions Faculty feel overburdened and pressured to work constantly to meet the demands of academia, and they strive for work–life balance. Faculty report stress and burnout related to excessively high expectations, financial pressures to obtain research funding, limited time to manage their workload, and a belief that individual progress is never sufficient. Faculty well-being is important for the individual and in support of scholarship and student outcomes. This article concludes with strategies to improve faculty well-being that incorporate an intentional focus on faculty members themselves, prioritize a community of well-being, and implement continuous high-quality professional learning.
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Prior to the rapid onset of COVID-19, higher education faced a mental health crisis. The COVID-19 outbreak both created and exacerbated stressors for students, with early evidence suggesting that the pandemic has had a significant negative impact on student mental health. The response of the engineering education community to adapt instruction during the pandemic has demonstrated our ability to quickly adapt and reimagine engineering education to protect student physical health. What can we learn from the COVID-19 crisis to address mental health and prioritize student wellness? Engineering culture has been described as having ideals of toughness and hardship that may promote poor self-care. As we reimagine higher education after COVID-19, we have the opportunity to build a culture of wellness in engineering to support student mental health and wellness, shifting the narrative in engineering from one of suffering to one of thriving.
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Background: Wellness champion teams can be a critical "grass roots" strategy in building a culture of worksite wellness; however, little is known about key elements of programs to prepare individuals for this role and their level of impact. Aim: To describe the components of a worksite wellness champion program at a large public land grant university in the Midwest and the characteristics of individuals who participate in this role. Methods: The Wellness Innovator program components, including processes of recruitment and retention, as well as demographic data of the Innovators are described. Results: 464 Innovators currently serve in the role. Support from supervisors/managers is key for sustained Innovator engagement. Conclusions: The Wellness Innovator program is an important strategy in encouraging faculty and staff to participate in wellness activities and services. More research is needed to determine the impact of wellness champion teams on health and wellness outcomes.
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The purpose of this paper is to describe the multifaceted nature and benefits of worksite health promotion programs (WHPPs), with emphasis on the college setting. An assessment of the peer-reviewed literature was conducted of articles published since 2000. Several search engines were accessed and selected key words were used. Most studies examining WHPPs have focused on return on investment and productivity. Research that targets the softer side-benefits of health promotion programs in the workplace is less available. Although the college setting offers some advantages for implementing health promotion programs. They may also have unique challenges due to their large and diverse employee population. There is little research to show the effectiveness and unique challenges of college-based health promotion programs.
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Objective: To respond to the question, "Do workplace health promotion programs work?" Methods: A compilation of the evidence on workplace programs' effectiveness coupled with recommendations for critical review of outcome studies. Also, reviewed are recent studies questioning the value of workplace programs. Results: Evidence accumulated over the past three decades shows that well-designed and well-executed programs that are founded on evidence-based principles can achieve positive health and financial outcomes. Conclusions: Employers seeking a program that "works" are urged to consider their goals and whether they have an organizational culture that can facilitate success. Employers who choose to adopt a health promotion program should use best and promising practices to maximize the likelihood of achieving positive results.
Importance Employers have increasingly invested in workplace wellness programs to improve employee health and decrease health care costs. However, there is little experimental evidence on the effects of these programs. Objective To evaluate a multicomponent workplace wellness program resembling programs offered by US employers. Design, Setting, and Participants This clustered randomized trial was implemented at 160 worksites from January 2015 through June 2016. Administrative claims and employment data were gathered continuously through June 30, 2016; data from surveys and biometrics were collected from July 1, 2016, through August 31, 2016. Interventions There were 20 randomly selected treatment worksites (4037 employees) and 140 randomly selected control worksites (28 937 employees, including 20 primary control worksites [4106 employees]). Control worksites received no wellness programming. The program comprised 8 modules focused on nutrition, physical activity, stress reduction, and related topics implemented by registered dietitians at the treatment worksites. Main Outcomes and Measures Four outcome domains were assessed. Self-reported health and behaviors via surveys (29 outcomes) and clinical measures of health via screenings (10 outcomes) were compared among 20 intervention and 20 primary control sites; health care spending and utilization (38 outcomes) and employment outcomes (3 outcomes) from administrative data were compared among 20 intervention and 140 control sites. Results Among 32 974 employees (mean [SD] age, 38.6 [15.2] years; 15 272 [45.9%] women), the mean participation rate in surveys and screenings at intervention sites was 36.2% to 44.6% (n = 4037 employees) and at primary control sites was 34.4% to 43.0% (n = 4106 employees) (mean of 1.3 program modules completed). After 18 months, the rates for 2 self-reported outcomes were higher in the intervention group than in the control group: for engaging in regular exercise (69.8% vs 61.9%; adjusted difference, 8.3 percentage points [95% CI, 3.9-12.8]; adjusted P = .03) and for actively managing weight (69.2% vs 54.7%; adjusted difference, 13.6 percentage points [95% CI, 7.1-20.2]; adjusted P = .02). The program had no significant effects on other prespecified outcomes: 27 self-reported health outcomes and behaviors (including self-reported health, sleep quality, and food choices), 10 clinical markers of health (including cholesterol, blood pressure, and body mass index), 38 medical and pharmaceutical spending and utilization measures, and 3 employment outcomes (absenteeism, job tenure, and job performance). Conclusions and Relevance Among employees of a large US warehouse retail company, a workplace wellness program resulted in significantly greater rates of some positive self-reported health behaviors among those exposed compared with employees who were not exposed, but there were no significant differences in clinical measures of health, health care spending and utilization, and employment outcomes after 18 months. Although limited by incomplete data on some outcomes, these findings may temper expectations about the financial return on investment that wellness programs can deliver in the short term. Trial Registration Identifier: NCT03167658
Objective: To examine changes in diagnoses/treatment for 12 mental health (MH) conditions, previous use of campus MH services, and willingness to seek MH services in the future. Participants: ACHA-NCHA II participants from 2009 to 2015 (n = 454,029). Methods: Hierarchical binary logistic regression with step 1 controlling for demographics and step 2 considering time. Results: Time was significant except for bipolar disorder, bulimia, and schizophrenia with increases for all conditions except substance abuse. Anxiety (OR = 1.68), panic attacks (OR = 1.61), and ADHD (OR = 1.40) had the highest odd ratios. Use of MH services at current institution (OR = 1.30) and willingness to utilize services in the future (OR = 1.37) also increased over time. Conclusions: Based on a national sample, self-reported diagnoses/treatment of several MH conditions are increasing among college students. This examination of a variety of MH issues can aid college health professionals to engage institutional stakeholders regarding the resources needed to support college students' MH.
In many respects, employers are well positioned to take a leading role in helping create a culture of health. Employers have access to many programs that could be beneficial to their employees’ health. The potential for financial gains related to health improvement may motivate employers to offer these programs, and if the gains are realized, they may help finance the programs. At the same time, employers’ involvement in such programs may create substantial risks. Enthusiasm about the financial and health gains that wellness programs might yield coexists with concerns about health costs shouldered by employees, the possibility of employment discrimination, and the potential for employers’ invasion of employees’ privacy. A fragmented regulatory regime, including a recently issued final rule under the Americans with Disabilities Act, has been created to address these concerns. Whether the regime strikes the right balance between wellness program benefits and risks remains to be determined.
Objective: The aim of the study was to identify key success elements of employer-sponsored health promotion (wellness) programs. Methods: We conducted an updated literature review, held discussions with subject matter experts, and visited nine companies with exemplary programs to examine current best and promising practices in workplace health promotion programs. Results: Best practices include establishing a culture of health and using strategic communications. Key elements that contribute to a culture of health are leadership commitment, social and physical environmental support, and employee involvement. Strategic communications are designed to educate, motivate, market offerings, and build trust. They are tailored and targeted, multichanneled, bidirectional, with optimum timing, frequency, and placement. Conclusions: Increased efforts are needed to disseminate lessons learned from employers who have built cultures of health and excellent communications strategies and apply these insights more broadly in workplace settings.
This study investigated the longitudinal associations of health perceptions and behaviors with subsequent academic performance among college students. Multiple health perceptions and behaviors were assessed for 203 college students both at the beginning and end of an academic year. Students’ academic performance was also measured at the end of the year. Separate regression analyses were conducted for men and women to examine changes in health perceptions and behaviors as predictors of yearend performance. Significant gender differences were found for initial health symptoms, perceived stress, exercise, and nutrition. After controlling for prior achievement, increased binge drinking negatively predicted female students’ academic performance and feelings of success; increased tobacco use negatively predicted male students’ performance. Male and female college students appear to differ in the ways that their health changes over an academic year as well as how such changes impact their later academic performance. Implications for devising health promotion programs that specifically target male and female college students’ health risks are discussed.
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