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Healthy by Design: ACHA-NCHA and the Ecological Approach KAREN S MOSES Director, ASU Wellness and Health Promotion December 2006.

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Presentation on theme: "Healthy by Design: ACHA-NCHA and the Ecological Approach KAREN S MOSES Director, ASU Wellness and Health Promotion December 2006."— Presentation transcript:

1 Healthy by Design: ACHA-NCHA and the Ecological Approach KAREN S MOSES Director, ASU Wellness and Health Promotion December 2006

2 What is Health? A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Health is instrumental in a persons ability to lead a socially and economically productive life. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April The Definition has not been amended since 1948.

3 What is Health? Health is the capacity of individuals and communities to reach their potential. It is not solely a biomedical quality measured through clinical indicators. Health transcends individual factors and includes cultural, institutional, socioeconomic, and political influences. NASPA Health in Higher Education Knowledge Community

4 Health Influences academic, personal and professional potential. Is multidimensional. Is influenced by interrelated variables. Occurs within complex systems. Requires complex strategies.

5 Ecological Approach Expands responsibility for health beyond the individual to the community and environment. Calls for community leadership to improve health.

6 Multiple Dimensions

7 Interrelatedness An action aimed at one variable will have side effects and long-term repercussions.

8 Systemic Influence Place Institution Community Person People

9 Complexity The existence of many interdependent variables in a given system. The more variables and the greater their interdependence, the greater that system's complexity. Great complexity places high demands on a planner's capacities to gather information, integrate findings, and design effective actions.

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11 Framework for Planning Problem Analysis Goals/Objectives Information Gathering Select Strategies Implement Evaluate & Revise Problem Identification Prediction & Extrapolation Model Formation

12 Common Mistakes Acting without prior analysis of the situation. Failing to anticipate side effects and long- term repercussions. Assuming that the absence of immediately obvious negative effects means that correct measures have been taken. Over-involvement in "projects" can blind planners to emerging needs and changes in the situation. Cynical reactions.

13 Variables within systems move "on their own". Requires: Knowing current status. Accurately predicting changes over time. Predicting how actions will influence the situation. How variables in the system are related. How variables in the system influence each other. If X increases, then Y will increase.

14 It is usually wise when correcting a deficiency to consider it within the context of its system. If we dont, we may treat only the symptoms and not the source of the trouble. We may also overlook the unpleasant side effects of our actions and do more harm than good in the long run. Considering the system means more than simply acknowledging the existence of many variables. It means recognizing the different ways the variables can affect one another and themselves. Deitrich Dorner in The Logic of Failure

15 Interrelationships Positive feedback Negative feedback Buffer Critical indicator

16 Systemic Plans Place Institution Community Person People

17 Representative Information Leadership Integrated Spheres of Influence Big picture

18 Good (more successful) planners are initially more cautious about acting, and try to secure a solid base of information. But too much information can lead to indecision and delay planning and action.

19 The more we know, the more clearly we realize what we dont know.

20 We must learn to think in terms of systems. We must learn that in complex systems we cannot do only one thing. Whether we want it to or not, any step we take will affect many other things. We must learn to cope with side effects, and understand that the effects of our decisions may turn up in places we never expected to see them surface.

21 Planning Questions Partners? Issues to address? Size Significance Potential to intervene Resources required Relevance? Campus values/mission? Student success? Student health/safety? Influences? Individual / Interpersonal / Institutional / Societal

22 HEALTH PROMOTION Dietitian HEALTH CENTER Lab Pharmacy Physicians Nurses STUDENT AFFAIRS Res Halls Judicial Affairs Dining Student Gov Recreation Complex Orientation Multicultural center Calendar Student Involvement Counseling CAREER Admissions UNIVERSITY Benefits Office Public Safety Employee Wellness Presidents Office Human Resources Training Entertainment/ Public Events Athletics Facility Management Colleges/ Areas of study Faculty Research Projects/ Centers Academic Senate Risk Management State Community (Grounds, Building) Nation World GET OUT OF YOUR COMFORT ZONE Involved: Disabled Ethnic/Racial International Gender GLBTQ Age Disability Resources

23 Using ACHA-NCHA Results for Ecological Planning Evidence based problem identification Population wide Subgroup specific Problem analysis/ Information gathering / Model formation Related issues Significance Setting Goals / Objectives Prediction and Extrapolation Evaluate: System wide outcomes/trends Building a Case

24 Problem Identification Population Wide Description ASU NCHA 2000 ASU NCHA 2002 ASU NCHA 2004 ASU NCHA 2006 National NCHA 2005 Had 5 or more drinks in a sitting in the last two weeks Had 5 or more drinks the last time you partied/socialized Think the typical ASU student had 5 or more drinks last time Combined, never used alcohol + have used, but not in the last 30 days

25 Problem Identification Subgroup Specific Gender Class Sexual orientation Ethnic minority identity International status Disabled Living arrangements

26 Problem Identification Subgroup Specific Description ASU 2004 n=738 ASU 2004 On campus n=104 ASU 2004 Off campus n=431 ASU 2004 Parents house n=128 Had 5 or more drinks in a sitting in the last two weeks Had 5 or more drinks the last time you partied/socialized Think the typical ASU student had 5 or more drinks last time Combined, never used alcohol + have used, but not in the last 30 days Affected academic performance Est BAC 0.08 or higher Received alcohol/drug use prevention

27 Problem Identification Subgroup Specific

28 Problem Analysis Related Issues Alcohol Stress BMI

29 Alcohol use is related to… Academic impediments Symptoms of depression Illegal drug use Tobacco use Number of sex partners Condom use Sexually transmitted infections Sexual violence Abusive relationships Dieting ASU ACHA-NCHA 2004 data (n=738)

30 Stress is related to… Depression Perceptions about weight Weight loss attempts Illness Alcohol/drug use Sex ASU ACHA-NCHA 2002 data (n=1,149)

31 High BMI is related to… High blood pressure High cholesterol Back pain ASU ACHA-NCHA 2004 data (n=738)

32 Problem AnalysisSignificance Rank Order Condition/ExperiencePerformance affected by population Experienced this by population Experienced this by performance affected 1Attention Deficit Depression/Anxiety/SAD Learning Disability Other Sleep Difficulty Stress Mono Relationship difficulty Death of friend/ family URI

33 Building a Case For your spheres of influence Internal Team Wellness Partners Student Government Student Affairs Academic Affairs Administrators Community For your funding partners

34 System Wide Outcomes/Trends Trends to follow Appropriate change in direction

35 To produce positive outcomes at the population level requires complex, integrated strategies that will have impact over time.

36 Campus Health Concerns

37 Environmental Influences Negative PlacePeople InstitutionCommunity

38 Environmental Influences Positive PlacePeople InstitutionCommunity

39 Challenges Training needs. Campus investment in individual methods. Change is slow. Examples limited. Campus commitment to health promotion. Involve the campus community. Provide training opportunities.

40 Resources NASPA Health in Higher Education Knowledge Community Health Education Leadership Program Leadership for a Healthy Campus US Department of Education Higher Education Center Environmental Management booklet Dorner, D. (1996) The Logic of Failure: Recognizing and Avoiding Error in Complex Situations. New York: Metropolitan Books.


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