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'» *‘E' - 42 E H E‘tgigEul-Enggl. :‘EEEEEELSEE13;thitzEzEEEEEfiEfi-Ezfia £31235; BEEEEEE . ' y ' U . g E “uh-”3.9. Ffityfiiém , w ___ MINTI'IIIIYUTIIVITNIHl L. 3 1293710716 1246 This is to certify that the dissertation entitled A COMPARATIVE ANALYSIS OF SCORES ON A WELLNESS INVENTORY AMONG STUDENTS AT A UNIVERSITY WITH A WELLNESS PROGRAM VERSUS STUDENTS AT A COMPARABLE UNIVERSITY WITH A TRADITIONAL HEALTH PROGRAM presented by L. Joan Hui] has been accepted towards fulfillment of the requirements for Ph.D. Educationai degree in . Aam1n1strat10n WW Major professor 551/ -% Date Mtlliumlfl' r “ "1 ”‘r ' ' ‘ ' 0-12771 MSU LIBRARIES .m— RETURNING MATERIALS: Place in book drop to remove this checkout from your record. FINES will be charged if book is returned after the date stamped below. iadrAgfi; _ .‘.;)r<3e the connotation of a histrionic response to an emotion. ¥_—_ 28 new focus is emerging which is characterized by an alternative and radical approach to the individual's health and health care delivery. Alternative medicine recognizes the inextricable interaction between the person's psychological being and between his/her psycho— social environment. Mind and body function as an integrated unit and health exists when they are in harmony, ‘ while illness results when stress and conflict disrupt this .1 unity (Gage, 1983; Pelletier, 1982; Selye, 1978). i H This approach to health and health care is respectful, ‘ harmonistic, and reestablishes an emphasis on the patient. It adopts natural, low technological, or non-invasive Strategies to meet health needs. It teaches individuals to monitor, respect, and be responsible for themselves and their environment while in health rather than in sickness. It Calls for the acknowledgement of the natural regener- ative powers of the body and an awareness of the mind—body 1 interaction in vis medicatrix naturae. Thus, it strives \\ for asymmetry that augments provider power over the ConSumer. It is the I-thou of alternative medicine and not the we-it of the orthodox approach (Cousins, 1981). The obvious mismanagement of resources, the waste of hUman potential through disrespect and disregard, and a breakdown of familial and economic structures have left (2 . . ontemporary society with a host of indiVidu'als ¥__—_—i4_4 29 experiencing deterioration of their psycho-social— immunologiCal entity. The subject of stress and its consequences on an individual's entity is a current issue under investigation. The appropriate measures to safeguard against and/or treat stress-related illnesses are still in question. However, given the fact that stress is debilitating, the urgent need for techniques to combat its manifestations deserves much clinical inquiry (Pelletier, 1982; Selye, 1978). Stress affects both genders and all ages, cuts across all social and economic class lines, and is not subject to an. ethnic or color bar. Acknowledging stress and its subsequent harm is difficult at times; however, to maintain hOnHeostasis and an understanding of somatic illness, one must. be able to distinguish between injurious and non- injtrrious stress. Prolonged, unidentifiable, unabated Stress is primarily responsible for the development of StreSs-related disorders, thus preventing sufficient reCc>‘Very from the stress-alarm reaction. With non“injurious stress, a normal, adaptive stress reactionr OCCUITS when the source is identifiable and individual can maintfiiin by returning quickly to an adequate level of functioning (Pelletier, 1982). StJTess is a state manifested by a specific syndrome W ' . hlch Chonsists of all the non-specifically induced changes ‘ 30 within the biological system. This stress has its own characteristic form and composition, but no particular cause. The elements of this form are the visible changes due to stress, whatever its cause. There are additional indicators which can express the sum of all different adjustments that are going on in the body at any time or stress may simply be the psychological apparatus involved in emotional or aroused reaction to threatening or unpleasant factors in the life situation as a whole (Selye, 1978). Reports vary as to percent of stress-related illness, however, 50-80 percent is commonly acknowledged in most Current popular literature, while some reports argue as high as 90 percent (Ward, 1982). Specific illnesses identified are peptic ulcers, mucous colitis, ulcerative Colitis, bronchial asthma, atopic dermatitis, urticaria and angioneurotic edema, hayfever, arthritis, Raynouds' disease, hypertension, hyperthyroidism, amenorrhea, neurOsis, paroxysmal tachycardia, migraine headaches, impotency, general sexual dysfunctions, sleep onset insomnia, alCoholism, and the whole range of cardiac and other Vascular diseases, as well as neurotic and psychotic disorders (Pelletier, 1982). Other more chronic debilitating diseases under investigation include collagen ciis . . eaSe, carcinogenic disease, metabolic disease, and 31 long-term episodic psychosis (Pelletier, 1982; Simonton and Simonton, 1975). Genetic predisposition is acknow- ledged; however, latent carriers reacting non—therapeutically to the stress alarm are a concern with today's health scientists and practitioners (Pelletier, 1982). Such prominent medical researchers as Bernard, Wolff, Pavlov, Cornon, Selye, Simeons, and Finberger have developed a foundation of empirical evidence in the mind-body interaction and the negative effects of stress on its homeostasis. They acknowledge that all disorders, are stress-related in the sense that both mind and body are involved in the etiology. Any disorder is created out Of' a complex interaction of social factors, physical and Psychological stress, the personality of the person subjected to these influences, and the inability of the Person to adapt adequately to pressure (Pelletier, 1982). With the recognition of the complex interaction of faCtors, the possible identifiable symptoms may be assessed as Well as their causation. However, the curative measures imposed on the individual by orthodox Western practitioners have Often resulted in failure and iatrogenesis and thus SUbStantiate the call for new methods of treatment and Criteria for diagnosis. Evidence suggests that intrusive, sometimes heroic orthodox curative measures impose more 32 stress on the body when compared to techniques used to mobilize the natural recovery process (Gage, 1983; Illich, 1982). Recent empirical studies of the psycho-immunological entity have proved its powers in regeneration (Cousins, 1975). The most current and substantial literature on natural treatment is within the area of relaxation response. Benson (1975) has popularized this concept. He notes major physiological changes: "decrease oxygen consumption and. carbon dioxide elimination, decrease heart rate, respiratory rate, arterial blood lactate, and skeletal muSele tension, accompanied by increased alpha and OCCasional theta activity in the electroencephalogram. For‘ any given system or individual, these changes vary but there is a definite tendency for them to occur COllectively" (Pelletier, 1979, p. 120). There are certain characteristics that Benson and his Colleagues have identified as conducive to eliciting the relaxation response: 1) Mental Device: There should be a constant stimulus - e.g., a sound, word, or phrase repeated silently or audibly, or fixed gazing at an object. The purpose of these procedures is to shift away from logical, externally-oriented 'thought. reiii A. 33 2) Passive Attitude: If distracting thoughts do occur during the repetition or gazing, they should be disregarded and the attention should be redirected to the technique. One should not worry about how well one is performing the technique. 3) Decreased Muscle Tonus: The subject should be in a comfortable posture so that minimal muscular work is required. 4) Quiet Environment: An environment with decreased environmental stimuli should be chosen. Most techniques instruct the practitioner to close his (sic) eyes. A place of worship is often suitable, as is a quiet room (Pelletier, 1979, p. 120). Empirical studies have brought credibility to various meditative practices that date back over 2000 years. ThrCngh physical and behavioral clinical testing, alter- ations in an individual's psychological state accompanying meditation seem to be opposite to those characteristics of Stress reaction. As reported by Tart, 1969; Lawrence, 1972; Forem, 1973; and Pelletier, 1982 such changes are evident also in mutual biological states through such alterations as (1) reduction of the metabolic rate (Anand, Chhina: and Singh, 1961; and Kasamatsu and Hirai, 1966), (b) redUCtion of the breathing rate to four-to-six breaths per minute from 12-14 per minute (Allison, 1970), (c) an 34 increase in the number of alpha waves of eight to twelve cycles in the brain (Akishige, 1970; Kamiya, 1968; Pelletier, 1974), (d) the appearance of the theta of five to eight cycles in the brain (Green, 1974; Pelletier, 1974), (e) a twenty percent reduction in blood pressure of hypertensive patients (Dotey at al., 1969), and other related reports from psycho-immunological research conducted with trained practitioners of transcendental meditation. ~According to Tart et. a1. further scientific evidence Substantiates the benefits of meditative practices of Indian yogis through their ability to manipulate the autonomic system (Brasse, 1946; Wallace, 1970; Stroebel, 1975). Such empirical evidence suggests more stable Psychological functioning (Schwarts & Galesman, 1974), autonomical stability (Orme-Johnson, 1973), less anxiety (Ferguson and Gown, 1973; Linden, 1973; Nidich, Seeman, and DreSken, 1973), and ability to experience an internal locus of control (Pelletier, 1982; Schwartz and Galeman, 1974). Another non-invasive technique for stress reduction is biofeedback is the technique used to mediate a state of deep relaxation through the use of subliminal imagery, fantasies, and sensations, thus producing relaxation outSide «of the laboratory. The psycho—immunological CarrY‘OVer benefits are well documented, and many credit biOfeedback as the most valuable form of stress reduction 35 used in the twentieth century medicine. "Autogenic training is based on a well-researched method of meditation, of all the systems noted, it is the most comprehensive and can serve as a model for all others that address themselves to clinical treatment of psycho- somatic disorders" (Pelletier, 1979, p. 121). Out of the developmental experiments of its initiator Johannes H. Schultz (1932), in its original form DAS Autogene Training calls for exercises which are developed within. "The techniques developed and used in autogenic therapy have been designed to support and facilitate the natural Self-healing mechanisms that already exist. Thus, the emphasis is not in trying to control the nature system, but rather on helping natural systems use their inherent POtentials of self-regulatory adjustment more fully" (Pelletier, 1979, p. 121). Autogenic training, a comprehensive and purposeful deep relaxation technique, reports the same results as those of diligent meditation (Mason, 1985). This method is a rational physiological exercise designed to produce a general psycho-immunological reorganization in the subject which makes him/her manifest all the phenomena otherwise obtainable through hypnosis. The technique of visualization is the summarizing and h°1din9 of certain images in the mind for examination and exPlOration of the efforts on consciousness (Pelletier, 36 1982). This methodology is credited as substantial in reducing the body's reaction to injurious stress, and this finding has prompted innovative clinical and experimental investigation into its therapeutic effects on specific dysfunctions, as with the Simonton and Simonton (1975) cancer research and visualization. Other considerations are research in more obscure areas. Through the personal experience of Cousins (1968), the inscrutable question arose: "if negative emotions Produce negative chemical changes in the body, would the Positive emotions produce positive chemical change? And is it possible that love, hope, faith, laughter, confidence, and the will to live have therapeutic value or dO <3hemical changes only occur on the downside?" (Cousins, 1981, p. 34). Clinical inquiry is modest; however, Scientific research into the immunological benefits of laughter indicate a positive interaction on psycho- immunological harmony (Fry, 1977; Paskind, 1932). University of Minnesota researchers, who study the chemical composition of tears, "have recently isolated two important chemicals, leucine-enkephalin and prolactin, from emotional tear" (Brody, 1984, p. 6). The first pOSSibly being an endorphin. Also, Frey (1984) reports that "tears are an exocrine substance - something produced by the body that is released to the outside, like sweat, 37 urine and exhaled air - and that all exocrine processes rid the body of toxins" (p. 6). Furthermore, continued research might find that "tears cleanse the body of substances that accumulate under stress" (p. 6). The old, frequently-held theory of "everything in moderation" has continued to be the unwritten rule for 900d health as is the recognition that proper nutrition, exercise, are correlated with longevity, as are well- balanced diet, vigorous, continual physical activity, and inVOlvement in community affairs to the end of one's life (Cousins, 1981). As an outcome of the various discussions of twentieth century health issues and the structural breakdown of SOCiety, an attempt to mobilize alternatives and curtail stress-induced damage to the human entity is underway. In the forefront of contemporary medical literature and cliJIical investigation is the concept and practical reality of wellness medicine. Wellness medicine views health as, "A dynamic state of being that changes daily rather than a static dimension. ThUS, there are as many degrees of wellness as there are degrees of illness" (Fletcher, 1983, p. 87). Wellness medicine emphasizes a shift away from crisis orientated health care that depends on high-technology and medication. wellness is an orientation that seeks to enrich and promote 38 that seeks to enrich and promote life-style activities that foster well-being. In common with the alternative health movement, wellness medicine offers a possible paradigm for integrating concepts, strategies, and action. It maintains a positive View of health as well-being, individual responsibility for health, the importance of health education, control of social and environmental chaterminants of health, and low-technological therapeutic techniques (Fletcher, 1983). Wellness medicine strives to rekindle the consumers' interest in health responsibility and the ethical standards 0f? their practitioners, and to promote and maintain Well-being rather than merely treating tflua symptoms. Wellness medicine attempts to re-educate society to the regenerative powers of the psycho-social-immunological entity by maintaining respect, regard, and knowledge for this; system. It also holds in esteem specific non-invasive teChniques as previously mentioned. ‘Wellness medicine provides a paradigm for building Upon cuiginal, Greek medical thought and incorporating new empirical evidence of concepts and techniques. It Substantiates the concept of an integrated whole, capable of regeneration given a modest amount of respect. Wellness medicine proposes an individual's responsibility for hiS/her own health care and stresses the crucial 39 implications of the social and environmental interplay upon an individual‘s treatment based on empirical scientific evidence, and it stresses the importance of health education. Wellness medicine is not without its critics, however. To many, it conjures of off-beat, non-empirical based alternatives. Some feel it is the fashionable medical trend of the 1980's that lacks systematic and sustained Verification. Further criticism is the social mandate that calls for total responsibility of the individual to maintain health and prevent illness; this is wellness medicine's most critical component. As Stein (1982) argues, Obsessive preoccupation with health is one among many contemporary expressions of narcissistic, inward- -turning that follows a sense of frightened impotence to affect change on the world . . . contracting disease has come to be seen by many as a sign of personal moral failure to maintain fitness . . . Wellness not only compounds the problems it proports to solve, but becomes itself the disease from which we must find a way to recOver. (p. 641) Other evidence of contention towards the wellness moVement is the argument of the lack of biological evidence. This compounded with various professional denials of its validity has left little agreement on its ability to serve as an alternative approach. 40 There is agreement as to the basic ingredients that impact on health; however, there is less agreement on the value assigned.tx) each. Genetic, behavioral, environmental, and medical characteristics must be weighed le this argument. Whatever the issues are and whichever approach is the most appropriate, the questions warrant concern and need to be evaluated with empirical scientific evidence. Diffusion Efforts But with test data comes the question of an appropriate diffusion strategy: what is the best vehicle for dissemination? Most research on health education agrees with the executive director of the American College Health Association that individuals are shaped by the attitudes, knowledge, and behaviors adopting during high-school and college (Dilley, 1983). It is for this reason that wellness and self-care programming for college students is so vital and should be rigorously explored and evaluated. Furthermore, according to Barth and JOhnson (1982), COllege and university health service personnel have a unjline and vital opportunity to influence young people in areas of general health and personal well-being before Chronic problems set in. Thus college can be an environment where self-awareness is encouraged and 41 reinforced. The time spent at a university is a time when many health habits and practices are initially developed and may persist throughout the remainder of one's life (Barth and Johnson, 1982). If the role of the university is not just to teach academic subjects, but also to produce well-rounded individuals, then the university must address the promotion of wellness among its students - not just provision of treatment for illness, nor even merely illness-prevention service (Dunn, 1977). This is not only to be for the present, but for the future of each student (Duncan, 1980). And as Taylor and McKillip (1980) conclude, even in a relatively healthy college population, personal habits can be shown to have immediate health-related consequences; therefore, positive health efforts can help avert the discomfort of illness and the expense of treatment in the present as well. In addition, examination of the relationship among the personal habits observed suggests that relatively close student lifestyles may have different implications for planning. Therefore, a need for wellness education is indicated. From a strictly financial point of view, wellness medicine is warranted for colleges and universities. Wel lness medicine addresses the high cost of twentieth Cehtury health services and thus makes itself valuable to 42 the institution and far less vulnerable to attack le‘the face of budget constraints. Student Development Developmental scholars differ on the building blocks of cognitive and affective development. However, consistent elements can be found among the more substantial theories; the importance of individuality in maturation and growth, and the notion that "development is continuous and discontinuing" (Wadsworth, 1978). Each critical item of psychosocial strength is systematically related to and built upon all the others (Erikson, 1950). And, according to Sylvia Ashton-Warner (1963), continuous development means that each subsequent development builds on, incorporates, and transforms previous development. If institutions of higher education are to have an impact as change agents, roles and responsibilities must be identified including those of faculty and staff. They must become advocates to implement the developmental processes of their constituents - the Students. .Ln every society there exist institutions for the socialization of its members which foster personal development. In our society we have schools, colleges, summer camps, military schools, training programs, the Peace Corps, penal institutions, psycho-therapeutic relationships, and a wide range of other, similar agencies and programs. While their goals may differ, these are- all agencies through which an individual passes 43 for a limited time for the purpose of being changed in some desired way. (Nevitt, 1966, p. 40) Among the various institutions serving young adults, institutions of higher education hold a special responsibility in their function as change agents. According in) Hettler (1980), "acquisition of appropriate mentoring and modeling in intellect, emotions, physical, social, occupational, and spiritual development is essential for optimal development during the college years (Leafgreen, 1981, p. 26). In essence, ”provide an optimal, holistic, human functioning for all individuals" (p. 26). Acknowledgment of individuality is the key element in developing programs that will foster all aspects of one's evaluating persomae. According to Leafgreen (1981), Assistant Chancellor of the University of Wisconsin-Stevens Point, tine specific mission of educators and student personnel professionals is three-fold: "facilitate change, growth and development by directing students in specific experiences, programs and strategies" (p. 32). Leafgreen et. al. quoted Austin's (1977) findings and emphasized that: . . . students do not follow uniform patterns of development during their undergraduate years . . . . several patterns of students' development are stereotypical, few students follow any given path exactly as portrayed. These patterns serve to dramatize the great behavioral developmental differences that characterize what has to be called the college experience. (p. 31) . 44 Paradigm Shifts To develop a holistic approach to health that will be consistent with the new physics and the systems view of living organism, we do not need.1x>lbreak completely fresh ground, but can learn medical models existing in other cultures. Modern scientific thought - in physics, biology; and psychology - is leading to a View of reality that comes very close to the views of mystics and of my traditional cultures, in which knowledge cu: human mind and body and practice of healing are an integral part of natural philosophy and of spiritual discipline. A holistic approach to health and healing will therefore be in harmony with many traditional views as well as, consistent with modern scientific theories (Capra, 1982, p» 305). In twentieth century America, old assumptions are being challenged and new ideas articulated. Ihn science and technology a paradigm shifts is occurring as a response to our societal crisis. 'Uk paradigm is a scheme for understanding and explaining certain aspects of realty . . . A paradigm shift is a distinctly new way of thinking about old problems" (Ferguson, 1980, p. 6). Scientific communities may respond in ways that make the shift subject to frustration and often bitter debate. Many people hold to the past, emotionally and habitually maintaining the old familiar truths. As Kuhn points out, "they usually go to their graves unshaken. Even when confronted with overwhelming evidence, they stubbornly stick with the wrong, but familiar“ (Ferguson, 1980, p. 28). 45 Essential to paradigm shifts is building upon past empirically-based theory and constructs, thus making for construction not destruction. This is the credible evidence needed for scientists to accept change. A crucial motivation for paradigm shifts is the need to View the subject as a whole and not to seek answers to questions at the level in which they are asked. Understanding the word ”context" is the key to understanding paradigm shifts. Literally, "context" means "the part or parts of a written or spoken passage preceding or following a particular word or group of words and so intimately associated with them as to throw light upon their meaning" (Websters Third New International Dictionary, 1966, p. 492). To explore the new paradigm that superseded Newton's physics - Mathematical Principles of Natural Philosophy (usually called Principia) (1978), one can see it “resolved much unfinished business, anomalies, riddles that would not fit into the old physics. The old mechanical rules were not universal, they did not hold at the level of galaxies and electrons. Our understanding of nature shifted from a clockwork paradigm to un uncertainty paradigm, from the absolute to the relative" (Ferguson, 1980, p. 27). As one can see, these shifts build upon the past partial truths, and integrate them with new thoughts, strategies, and actions. 46 Paradigm shifts are regularly marked by periods of frequent and deep debates over legitimate methods, problems, and standards for solutions. These times serve to define schools rather than produce consensus. Paradigms do not need total agreement by the scientific community, but they do need the acceptance of basic rules used to produce knowledge. However, as stated above, different communities respond differently for whatever reasons. Many times they produce in—house fighting as to appropriate decisions. For example, developing rules in quantum mechanics (which was subject to a paradigm shift in the 1950's) provided bitter debate between the chemist and physicist as to the question of whether a single atom was or was not a molecule. This question has yet to be determined as an accepted rule; however, the debate has not conjured up a total splitting and alienation of the two schools of thought. It built upon old partial truths to produce new knowledge. And once we understand nature's transformative powers, we see that it is our powerful ally, not a force to be feared or subdued . . . In every age, said scientist-philosopher Pierre Teilhard de Chardin, man (sic) has proclaimed himself at a turning point in history. And to a certain extent, as he is advancing on a rising spiral, he has not been wrong. But there are moments when this impression of transformation becomes accentuated and is thus particularly justified. (Ferguson, 1980, p. 25) 47 Many feel the paradigm shift in health care delivery, service, and education is in such a period of debate. But unlike the chemical and physical science communities, the medical community is in a bitter debate as to alternatives based on sound empirical evidence and not just behavioral indicators. Kuhn acknowledges a popular acceptance of some scientific communities' lack of clinical inquiry into concepts they feel are irrelevant to their research. The scientists hold strong to their traditional mode of problem solving, and it is the general population that suffers form their acceptance of received knowledge. During a paradigm shift, proponents of the new system must face strong and entrenched opposition. Insurmountable at times, against all odds, the paradigm shift continues. To quote from Albert Einstein (1947), "Great spirits have also encountered violent opposition from mediocre minds." Paradigm shifts may be experienced in every aspect of society: health, education, law, business, civic and domestic affairs. Currently, the health services are experiencing a paradigm shift in which their structural basis is being questioned in its relevancy to treatment, technique, cost-implications, and social/ethical/pro- fessional responsibility. The shift is being manifested through a collaboration which includes varied professionals, consumers and victims 0f iatrogenesis. A Recent editorial in American Medical News, decrying medicine's crisis of human relations as follows: "Compassion and intuition are waylaid . . . Physicians must recognize that medicine is not their gmivate preserve, but a profession in which all people have a medical statesmanship failure - the patients' (sic) to correct a major senses of unrequited love" (Ferguson, 1980). The emergent paradigm of health appears below: THE EMERGENT PARADIGM OF HEALTH Assumptions of the Old Paradigm of Medicine Treatment of symptoms and causes Specialized Emphasis on efficiency Professional should be emotionally neutral Pain and disease are wholly negative Primary intervention with drugs, surgery Body seen as machine in good or bad repair Disease or disability seen as thing, entity Emphasis on eliminating SYmPtoms , disease Assumptions of the New Paradigm of Health Search for patterns and symptoms Integrated, concerned with the whole patient Emphasis on human values Professional's caring is a component of healing Pain and disease are information about conflict, disharmony Minimal intervention with "appropriate technology," complemented with full armamentarium of techniques (psychotherapies, diet, exercise) Body seen as dynamic system, context, field of energy within other fields Disease or disability seen as process . Emphasis on achieving maximum wellness, "meta-health" 49 Assumptions of the Old Paradigm of Medicine Patient is dependent Professional is authority Body and mind are separate; psychosomatic illness is mental, may be referred to psychiatrist Mind is secondary factor in organic illness Placebo effect shows the power of suggestion Primary reliance on quantitative information (charts, tests, dates) Prevention largely environmental: vitamins, rest, exercise, immunization, not smoking Assumptions of the New Paradigm of Health Patient is (or should be autonomous) Professional is therapeutic partner Body-mind perspective; psychosomatic illness is province of all health-care professionals Mind is primary of coequal factor in all illnesses Placebo effect shows the mind's role in disease and healing Primary reliance on qualitative information, including patients' subjective reports and professional's intuition; quantitative data as adjunct Prevention synonymous with wholeness, work, relationships, goals, body-mind-spirit (Ferguson, 1980, 246-248) p. With the contemporary ideas of the new practitioners and various schools of thought, is being investigated. throwing out a challenge: western orthodox medicine The scientific innovators are if our memories are as absorbent as research has demonstrated, our awareness as wide, our brains and bodies as sensitive, if we are heirs to such evaluating virtuosity, how can we be performing and' learning at such mediocre levels? why aren't we smart? rich, 297) If we're so (Ferguson, 1980, p. 50 The answer is the level of appropriate educational experiences. Education is one of the least dynamic of institutions, lagging far behind medicine, psychology, the media, and other elements of our society (Ferguson, 1980). Fantini, former consultant on education, now at the State University of New York, contends, "The psychology of becoming has to be smuggled into the schools . . . Only a new perspective can generate a new curriculum, new levels of adjustment just as political parties are peripheral to the change in the distribution of power, so the schools are not the first arena for change in learning" (p. 281). The negative implications of public, private, and parochial schools are seen in the impoverished expectations of students. "Our public schools were designed, fairly enough, 1x) create a modestly literate public, not to deliver quality education or to produce great minds" (Ferguson, 1980, p. 287). If our schools are to be the center of learning, then we must allow for innovation fur not separating learning from life. Individuals must recondition themselves to question partial truths and View the world as a whole, and not seek to answer questions at the level at which they are asked. The developing paradigm of education appears below: 51 DEVELOPING PARADIGM OF EDUCATION Assumptions of the Old Paradigm of Education Emphasis on content, acquiring a body of "right" information, once and for all. Learning as a product, a destination. Hierarchal and authoritarian structure. Rewards conformity, discourages dissent. Relatively rigid structure, prescribed curriculum. Lockstep progress, emphasis on the "appropriate" ages for certain activities, age segregation. Compartmentalized. Priority on performance. Emphasis on external world. Inner experience often considered inappropriate in school setting. Guessing and divergent thinking discouraged. Assumptions of the New Paradigm of Learning Emphasis on learning how to learn, how to ask good questions, pay attention to the right things, be open to and evaluate new concepts, have access to information. What is now "known" may change. Learning as a process, a journey. Egalitarian. Candor and dissent permitted. Students and teachers see each other as people, not roles. Encourages autonomy. Relatively flexible structure. Belief that there are many ways to teach a given subject. Flexibility and integration of age groupings. Individual not automatically limited to certain subject matter by age. Priority on self—image as the generator of performance. Inner experience seen as context for learning. Use of imagery, storytelling, dream journals, "centering" exercises, and exploration of feelings encouraged. Guessing and divergent thinking encouraged as part of the creative process. 52 Assumptions of the New Paradigm of Education Emphasis on analytical, linear, left-brain thinking. Labeling (remedial, gifted, minimally brain dysfunctional, etc.) contributes to self-fulfilling prophecy. Concern with norms. Primary reliance on theoretical, abstract "book knowledge." Classrooms designed for efficiency,.convenience. Bureaucratically determined, resistant to community input. Education seen as a social necessity for a certain-period of time, to inculcate minimum skills and train for a specific role. Assumption of the New Paradigm of Learning Strives for whole-brain education. Augments left-brain rationality with holistic, nonlinear, and intuitive strategies. Confluence and fusion of the two processes emphasized. Labeling used only in minor prescriptive role and not as fixed evaluation that dogs the individual's educational career. Concern with the individual's performance in terms of potential. Interest in testing outer limits, transcending perceived limitations. Theoretical and abstract knowledge heavily complemented by experiment and experience, both in and out of classroom. Field trips, apprenticeships, demonstrations, visiting experts. Concern for the environment of learning: lighting, colors, air, physical comfort, needs for privacy and interaction, quiet and exuberant activities. Encourages community input, even community control. Education seen as lifelong process, one only tangentially related to. schools. 53 Assumptions of the Old Assumptions of the New Paradigm of Education Paradigm of Learning Increasing reliance on Appropriate technology, technology (audiovisual human relationships equipment, computers, between teachers and tapes, texts), learners of primary dehumanization. importance. Teacher imparts knowledge; Teacher is learner, too, one-way street. learning from students. (Ferguson, 1980, pp. 289-291) Programming Efforts Within Institutions of Higher Education Introduction University professionals agree that the system has a responsibility to provide adequate opportunities for students to mature and develop through the use of university resources. To various institutions of higher education, wellness programming serves as an opportunity to provide such resources. Wellness programming within institutions is still a rather new concept, and one not universally accepted. Within the United States, the various programming efforts and achievements differ depending on an array of variables which directly and indirectly relate to the specifics of wellness medicine. For reasons of comparability and insight into various aspects of program development, i.e., budget, faculty, evaluation, etc., the author will provide brief descriptions of three mid-western 54 wellness programs operating within separate institutions of higher education. Southern Illinois-Carbondale Southern Illinois at Carbondale (SI—C) has been operating its wellness program since August, 1978. The program's goals are: l) to assist students in maintaining their health through a promotion of healthy living habits, and 2) to educate students in the methodology of self—treatment and to help them decide when self-treatment is appropriate. (Southern Illinois-Carbondale, 1984, p. 1). The Wellness Center has a philosophy of unconditional positive regard toward its students. It encourages maintenance, and other activities that significantly improve students' health so they remain in school and pursue their academic, career, and personal objectives with a high degree of concentration, commitment, and success. Out of this general commitment come their specific preventive and treatment services. With continued collaboration with the medical staff and other personnel, students identify their needs, and are provided pertinent information and education on such topics as stress management, pain management, birth control, pregnancy, nutrition, weight management, smoking cessation, alcohol and drugs, and athletic injuries. 55 Added instruction into the specifics of prevention, maintenance, and responsible health care are also integral components of wellness promotion at SI-C (See Appendix C). The Wellness Center's operating budget is provided entirely through annual semester student fees which are part of the overall medical benefit fee of $75.00. Six dollars of that $75.00 is assessed for the Wellness Center. Maintained on a budget of approximately $235,000, the Wellness center has a staff consisting of a director, coordinators for lifestyle programs, a coordinator for alcohol and drug education programming, a coordinator for special programs (minority, international, and disabled students), a coordinator of the student health assessment center, and a coordinator for the peer health advocates program. Also employed are three graduate assistants, two secretaries, and several student monitors. Approximately one-half of the staff are Master's degree health educators, with the remaining staff graduate counselors with rehabilitation and/or counselor-education backgrounds. Michigan State University Geared toward university students, specifically those residing in residence halls, Michigan State University's wellness program stresses the importance of "floor community". Developed in 1982 under the auspices of the University Housing Program and the Division of Student Affairs and Services, the program has professional and 56 support staff who play an active role in each student's wellness by disseminating both verbal and written information on the six dimensions of wellness (See Chapter I, p. 4). Four times a year "The Wellness Report," a newsletter, is distributed (See Appendix D). The newsletter offers pertinent information on various topics of wellness medicine and life-style improvement. In conjunction with their supervisors, resident assistants plan appropriate wellness programs per floor based on the identification of individual needs and desires of the students. Identification is assessed as supervisors and resident assistants work together to ascertain through developmental questions potential problems before they become critical, and develop programs for the desired and unrealized needs of the residents (see Appendices E). University of Wiscon§in-Stevens Point Wellness programming at the University of Wisconsin-Stevens Point started in 1972 under the general framework of lifestyle improvement. Spearheaded by the faculty of the Student Life Division of University Services, it maintains a philosophy of high-level wellness. The entire University of Wisconsin-Stevens Point program has been influenced by the work of Robert Allen of the Human Resources Institute (HRI) of Morristown, New Jersey. The '1ifegain” program developed by the HRI 57 focuses on evaluating the cultural norms that exist to support changes desired by the population. A university where external forces can be modified is an ideal location to attempt a wellness promotion program. the place where students live is supervised by university employees. The selection of resident assistants is within the control of the University. The food services contract can be modified toward wellness concepts. The university centers can be programmed to offer positive alternatives for evening activities. The health and counseling centers can be supportive with programs and individual consultation and another assistance is that most students are at the healthiest stage of their lives (Hettler, 1980). The widespread public support for higher education can be channeled toward wellness promotion within the university. If the citizens of tomorrow have more skills in dealing with the forces of society and develop positive health practices during college years, they will be more productive citizens and decrease the amount of illness care required in the future. As Don Ardell (1977) has stated, "High level wellness is more rewarding than low level wellness" (Hettler, 1980, p. 90-91). Keeping this in mind, the University of Wisconsin-Stevens Point acknowledges the function of the university is to provide an "atmosphere and physical environment in which the students have the opportunity to improve their knowledge, skills, and attitudes" (Leafgreen, 1981, p. 32). In 58 reference to the six dimensions of wellness, University of Wisconsin-Stevens Point feels most colleges and universities provide the atmosphere and physical environment for intellectual development; however, few colleges and universities, however, provide equal resources for improving the other five dimensions. This is the primary focus of the wellness promotions to emphasize not one but all six dimensions of wellness. For a variety of reasons, wellneSs promotion responds to and acknowledges societal-environmental stress and basic health indicators. The University of Wisconsin-Stevens Point attempts to assist students in establishing lifestyles that will serve them well into their later years, and will not lead to premature disability or death. In this regard the University has developed tailor-made programs that attempt to address relevant issues of health and lifestyle improvement (see Appendix F). Under the general framework of University of Wisconsin-Stevens Point Student Life Division are the following services: (1) university health services, (2) university counseling services, U3) resident hall programs, and (4) university centers. The directors of student life meet regularly to evaluate programs in an attempt to "minimize competition for the students' time, arrange for sharing personnel and resources, whenever possible provide on-going planning and 59 evaluation activities, and discuss problem solving difficulties that arise" (p. 81). The leadership of Student Life met in January 1979 to establish the following goals: 1) 2) 3) 4) 5) 6) to assist the University of Wisconsin-Stevens Point community in the creation of a healthy and safe environment and one that provides stimulation, order, privacy, and freedom; to provide opportunities that enhance the personal- growth and development of students intellectually, socially, emotionally, physically, spiritualhy, and vocationally; to provide services that support the academic mission of the community as well as services that enhance student's comfort in the community; to provide, through research, assessment of the efficiency of the current program and the direction for our future program; to maintain an effective and efficient delivery through resource responsibility - both fiscal and personnel; and to maintain an ongoing professional development thrust, reaching into the university community as well as outside of the community to collaborate with colleagues. (Hettler, 1980, p. 82) These goals have been simplified for Health Services to include three broad missions: 60 1) student services or traditional illness care; 2) student development or wellness promotion; and 3) outreach or creating a supportive environment on a local, state, and national basis. (Hettler, 1980, p. 82) The Lifestyle Assessment Questionnaire (LAQ), the assessment tool used by the university, is essential in the total health promotion program. Originally developed in 1976, the LAQ is subject to continued revision. It is this instrument that is recommended to the students as their entrance health assessment instrument. Traditional entrance requirements concerning health assessments were used prior to Fall, 1974. At this time the University of Wisconsin-Stevens Point modified its orthodox appraisal of health history and physical examination and added the option of completing a Data Automated Student History (DASH) questionnaire provided by Medical Datamation of Bellevue, Ohio. The added option gained credibility with the increased evidence that it was not cost effective to require a history and physical examination for young, healthy adults. Brakenbaker (1977) demonstrated that it is more cost effective to do a health hazard appraisal than history and physical examination when the goal was to identify significant health problems. His table below indicates the cost per unique problem from a variety of screening efforts (See Table 2.1). ‘E_ .Ahsma moousomom COaumoscm can rhinos u.c: .mcomruwme mosacomooum ocaoaoo: w>apowdmoym wo xuofloom .mCHuooz Hmscc< coma um caucwmwnd momma =.>m3 o>fluoomwmlumoo one oumo Hmuoa= .m .nwxmncoxcmflm "wousom om.a meow om.e Ha.m Homm was an: oe.oa see oo.oa em. «NH mam omu mm.o see oo.o om. mma mam memsemcaus oo.me on ma.oo am. we mam Aoa>Hoo rues. noosm moo He.me mos oe.va mm. mas mmm ma.eoru oa.mo om ma.ev am. we mos mom oo.ae on am.oa em. or on com oo.mm mm oo.me om. Hm mma omono Mm oo.amm N oo.Hmm Ho. m Hmm qmo> me.oew was oo.efiw ae.~ awe emm Hmoamsno .snoumam aflmmm lamaw. nmflflm .IdmmmW Eda Resend amid osgflco mEoHnoum Hod umou \msoflnonm msofinoum momma poo omoo ozone: no noossz Hobos mo nooesz manomwm mcflcoouom mo muwflum> < zone msofioono woven: suaocooH on umoo H.N mqm<fi 62 The Student Health Advisory Committee (SHAC) was initiated at.the University of Wisconsin-Stevens Point campus in 1972 and is the substantial educational component of their wellness promotion. The mission of the committee is to: 1) provide students with an opportunity for substantive and procedural involvement in policies of the health center, 2) improve the health center's services to regular and continued student involvement and input, and 3) aid in the dissemination of health-related information to student bodies and to conduct periodic surveys of student opinion regarding the Health Center. (Hettler, 1980, p. 87) SHAC's programming includes a peer education component which is divided into task forces of fitness, nutrition, contraception, interpersonal relationships, stress manage- ment, blood pressure screening, and dental wellness. Life-style improvement programs are conducted in the dorms and university center buildings. Included in their regimen are health fairs, lectures, programs for high schools, fun runs, regular blood pressure screening in the university center, alternative evening activities, and social events for the membership. Other SHAC activities take place during summer orienta- tion, in which parents are invited to attend health 63 promotion presentations by directors of the health service and counseling centers. These presentations outline the variety of services available to students and subsequent topics for discussion between parents and students during the trip home. At the conclusion of SHAC presentations, students are invited to leave their names and addresses if they are interested in becoming involved in various components of health promotion. SHAC membership thus invite consumer participation in all their education and prevention programs. Health promotion activities are sponsored in residence halls by resident assistants. Courses in various depart- ments develop around the theme of wellness and lifestyle improvement in the spirit of "evolving interest." In addition an intramural program has developed wellness clubs, and interest groups have promoted healthful changes in student cafeteria menus. Faculty involvement is widespread with a large percentage of faculty participating in LAQ seminars and receiving individual printouts with interpreting information (p. 90). Established track and pool times are posted for both students and faculty and dual purpose trails have been developed for running and cross country skiing. An employee assistance program has been 64 W Found within the review of literature are key issues central to the theme of this research study: a call for health care reform with the identification of psycho- immunological, historical, political and economic indices, a study of paradigm shifts in education and medicine, the viability of wellness as an alternative to orthodox medicine and appropriate diffusion efforts specifically those found within institutions of higher education. The latter has been provided as subsections on higher education, including developmental issues of college students; missions and responsibilities of institutions of higher education and finally an examination of three wellness programs operating with institutions in this country. L 1 CHAPTER III DESIGN OF THE STUDY Introduction The purpose of this study is to investigate the potentiality of the wellness movement within institutions of higher education and the movement's potential for changing health practices of college students toward the wellness philosophy of healthful living. This study will compare and analyze the attitudes, knowledge, and orientation of students from two separate institutions of higher education which are similar in many variables but differ in their approach to wellness programming. One institution provides wellness programming, while the other has no discernable effort in wellness programming. This descriptive analysis will compare the six wellness dimensions with their behavioral constructs: l) Emotional development emphasizes an awareness and 'acceptance of one's feelings. Emotional wellness includes the degree to which one feels positive and enthusiastic about oneself and life. It includes the capacity to manage one's feelings and related behaviors including the realistic assess- ment of one's limitations, development of autonomy, and ability to cope effectively with 65 2) 66 stress. The emotionally well person maintains satisfying relationships with others; Behavioral Construct Emotional Awareness and Acceptance: measures both the degree to which individuals have an awareness and acceptance of feelings, including the degree to which individuals feel positive and enthusiastic about them- selves and life; Emotional Management: measures the capacity to appropriately control one's feelings and related behavior, including the realistic assignment of limitations; Intellectual development encourages creative and stimulating mental activities. An intellectually well person uses the resources available to expand her/his knowledge in improved skills along with expanding potential for sharing with others. An intellectually well person uses the intellectual and cultural activities in the classroom and beyond the classroom combined with the human resources and learning resources available within the university community and the larger community; 3) 67 Behavioral Construct Intellectual: measures the degree to which individuals engage their minds in creative and stimulating mental activities, expanding knowledge and improving their skills; Physical Development encourages cardiovascular flexibility and strength and also encourages regular physical activity. Physical development encourages knowledge about food and nutrition and discourages the use of tobacco, drugs, and excessive alcohol consumption. It encourages activities which contribute to high level wellness including medical self care and appropriate use of the medical system; Behavioral Construct Physical Exercise: measures commitment to maintaining physical fitness; Physical Nutritional: measures the degree to which individuals choose foods which are consistent with dieting goals of the United States as published by the Senate Select Committee on Nutrition and Human Needs; 68 Physical Self-care: measures the behavior which helps individuals present or detect early illness; Physical Safety: measures individual safe driving practices which minimize chances of injury or death in a vehicular accident; Physical Drug Abuse: measures the degree to which individuals are able to function without the unnecessary use of chemicals; 4. Social Development encourages contributing to one's human and physical environment to the common welfare of one's community. It emphasizes interdependence with others and nature. It includes the pursuit of harmony in one's family; Behavioral Com§truct Social environmental: measures the degree to which individuals contribute to the common welfare of the community. This emphasizes one's interdependence with others and with nature; 5. Occupational Developmgmg is preparing for work in which one will gain personal satisfaction and find enrichment in one's life through work. 69 Occupational development is related to one's attitude about her/his work; and Behavioral Construct Occupational: measures the satisfaction gained from work and the degree to which one is enriched by their work; and 6. Spiritual Development involves seeking meaning and purpose in human existence. It includes the development of a deep appreciation for the depth and expanse of life and natural forces that exist in the universe. Behavioral Construct Spiritual: measures individual, ongoing involvement in seeking meaning and purpose in human existence; it includes an appreciation of the depth and expanse of life and the actual forces which exist lJl the universe. (Hettler, 1980, p. 3) Population The population from which the two samples were drawn consisted of students enrolled in spring and summer academic sessions within two comparable institutions. The institutions were chosen for their similarity of demographic data (student profiles) as well as subsidiary 70 composition (geographical, programming efforts, size, etc.). The population currently enrolled at the University of Wisconsin-Stevens Point consists of approximately 9,050. The current updated student profile data show a breakdown of characteristics which, according to Mosier (1981) and Elsenroth (1984), have similarities that are quite striking, leading one to believe that a consistent pattern exists throughout 1980-1985. The population currently enrolled at the comparative institution consists of approximately 7,033. Also, this institution is comprised of similar variables. Within these populations, this study was concerned only with freshmen through senior students with the Fall 1984 class and gender distribution as shown in Table 3.1. On matching subscale variables as closely as possible, one identifiable difference is perceived: programming efforts in wellness medicine. The University of Wisconsin-Stevens Point has provided wellness programming, whereas the comparative institution provides no concerted efforts in wellness programming. This does not imply that this institution does not provide healthful living instruction, and other tertiary health measures; it only implies no concerted, formal wellness efforts have taken place. 71 Table 3.1 Population University of Wisconsin Comparative Stevens Point Institution Gender Number Percentage Gender Number Percentage Male 4465 39.3 Male 3608 51.3 Female 4585 50.7 Female 3425 48.7 TOTAL 9050 100.0 TOTAL 7033 100.0 Class Class Fresh 2855 35.5 Fresh 2800 39.8 Soph 1623 20.2 Soph 1305 18.6 Junior 1514 18.8 Junior 1337 19.01 Senior 2052 25.5 Senior 1589 22.69 TOTAL 8044 100.0 TOTAL 7031 100.00 *Special Classification 447 ** *Concerning statistical measurements, consideration will not be given to the special classification of students. **No special classification cited for the comparative institution. Note: Due to the inability to sample during a typical academic session, the comparative programming institutions population must be considered biased. 72 In an effort to maximize exposure to programming efforts through consistent participation in campus life, the exclusion of non-resident-hall students in this population would have been ideal. However, due to logistical constraints of sampling, resident—hall students were not used exclusively. Sampling Procedure At the University of Wisconsin-Stevens Point Campus, the original sample size was four hundred students enrolled in the spring academic session, April 1985. A random sample was drawn with a class and gender distribution of one hundred from each class; freshmen, sophomore, junior, and senior with equal gender distribution of fifty males and fifty females in each class. A response rate of 134 respondents was reported. Specifically, the procedure was as follows: with the assistance of an administrative professional employed through the Department of Student Life, a request was made of the enrolled students who had previously taken the Life Assessment Questionnaire (LAQ). Included was a request for equal distribution of gender and class ranking. Initially the sampling procedure was to be computer generated, selecting every nth student until the needs were met. This procedure was altered due to the inability of the computer files to generate the needed data of class rank. The recommended solution was to have work study 73 of the computer files to generate the needed data of class rank. The recommended solution was to have work study students use the student directory and go down each page to locate students who had taken the LAQ. As this was done the data was compiled on prospective lists until the gender and class quotas were met (Renault, 1976). Due to the low response rate, a second sample was drawn in July, 1985 from students enrolled in the summer academic session. Specifically, the sample was computer generated, matching the proportions of the first sample. The respondents were paired (when available) with their initial LAQ and identified by code for data identification and interpretation. The first and second samples were combined for the analysis and the response rate was 134. Interpretation sessions were offered in September 1985 on two different dates. The sample was representative of the University of Wisconsin-Stevens Point student body (Renault 1985). However, a possible bias must be reported because the first sample was drawn preceding finals week, May 1985. Therefore, it should be considered that respondents fall disproportionately on those with an interest in wellness (Renault, 1985). Due to logistical concerns, the author was unable to draw a sample and assess the students at the comparative 74 institution during spring 1985. Therefore, the sample was drawn during the summer academic session, July 1985. Initially, the preliminary procedure consisted of a written request to the Associate Vice President for Academic Affairs and the Director of Research (see Appendix G). Upon approval of the Human Subjects Committee, permission was granted (see Appendix H). Specifically, the procedure was as follows: After receiving the requested class roster of an equal gender and class distribution with identification of teaching faculty, the author (through random choice) identified classes that might participate in the study. Via the telephone, perspective faculty were contacted and a thorough discussion of the sampling procedures, research study, and all other pertinent information was provided. At this time, permission was either granted or denied. During the month of July 1985, an assessment was done by entering the previously identified classes within the university. Following an introduction and explanation to the students, the author asked the student to take the Life Assessment Questionnaire home and bring it back to the next class period in completed form. Once this was done the questionnaire was collected and forwarded to the University of Wisconsin-Stevens Point for computer coding. A biased sample is to be considered as summer school students at the comparative institution are not necessarily 75 representative of "typical" academic year students. A sample was drawn on 200 students with a response rate of 108.1 History and Description of the Instrument The Lifestyle Assessment Questionnaire (LAQ) , second edition, is the assessment tool used by the University of Wisconsin-Stevens Point to measure high level wellness among its students. The LAQ was developed in 1976 and has undergone continuous revision. various facets of the evaluation have been done by a.cmmmdttee of the Student Life Division at the University. When deemed necessary, alterations were undertaken through suggestions from LAQ respondents and professionals throughout the country. 1Originally, this research study sought to compare students on the basis of class standing on the assumption that:<:lass standing (freshman, sophomore, junior, senior) would have a significant interaction with the Life Assess- ment Questionnaire scores (LAQ). Time and scores were to be measured and compared based on data ascertained by a repeated measure ANOVA. The repeated measure data was then to be broken down by class standing and measured against their freshman entry level LAQ scores (Chapter 2, p. 69). However, due to sampling limitations and computer inability to produce the data; this was not feasable. In an effort to generate data needed to determine exposure influence at the University of Wisconsin-Stevens Point, a one-way repeated measure was taken (most recent LAQ scores) and measured against group gain scores (entry level LAQ scores). A repeated measure was not done at the comparative institution because of sampling bias and a low response rate (Chapter 3, p. 71 and 74). 76 Measurements of the Lifestyle Assessment Questionnaire The following material has been taken from the University of Wisconsin-Stevens Point Lifestyle Assessment Questionnaire, second edition: An Interpretation (1980). The results of the Lifestyle Assessment Questionnaire are described below with the intention of helping the respondent assess his/her lifestyle behavior and current level of wellness (see Appendix I).- This interpretation model will also be useful in identifying health hazards respondents face at this particular point in their life (University of Wisconsin, 1980, Inside front cover). The major determinant for joyful living is you and your lifestyle. The circle graph below indicates the factors that contribute to increasing your enjoyment and quality of life. While it is true that doctors and hospitals have a significant role to play in the quality of our lives, this graph clearly indicates that it is individuals, through the choices that they make each day, that contribute the greatest percentage toward maximizing the quality of life and health. We believe this instrument can be a useful adjunct in helping individuals identify the most likely causes of death and disability, but more importantly‘ identify the areas of self-improvement which will lead to higher levels of joy and wellness. This instrument can be used to begin a positive, wellness approach toward living. It is our belief that this instrument can help people realize that they are the most important providers of health or 'illth' care. Many of the common killers in America are the direct result of individual behaviors. we all know that our behaviors can be described as our lifestyle. (p. 1) 77 fists-fling" ‘ O 2 Section 1: Wellness Inventory Section This section the Lifestyle Assessment Questionnaire is designed to help the respondents assess their current levels of wellness. The printout provides respondents with a percentage of possible points achieved from each lifestyle dimension of wellness in addition to the average score of people taking the questionnaire in their group, and the total average of all people who have ever used this instrument. The respondent's score is the percentage of possible points on the wellness statements. The higher the score, 78 the higher the level of wellness. lune following scores indicate each respondent's level of wellness compared with averages of people taking this survey with the respondent and averages of all people who have taken the survey: Your Group Total Score Average Average Physical-Exercise 79 67 58 Physical-Nutrition 85 81 66 Physical-Self Care 75 78 67 Physical Vehicle Safety 79 77 82 Physical Drug Usage 100 85 89 Social-Environment 80 84 73 Emotional-Awareness 88 90 83 Emotional-Management 84 88 76 Intellectual 72 63 66 Occupational 99 80 69 Spiritual 83 80 69 Composite Score 84 83 74 As can be noted on the sample, this person scored 79 percent for the Physical-Exercise section. This group - 67 percent, while the total population's average was 58 percent” ‘This format is followed through each dimension and allows the respondent to View his/her score in comparison with these two groups. Again, it is through taking responsibility for each of these dimensions of his/her lifestyle that the respondent can move to the right of the wellness continuum toward a richer, fuller, high quality life (p. 3). 79 Section II: Topics for Personal Growth The second section of the Lifestyle Assessment Questionnaire is designed to aid respondents in utilizing a computer as an automatic questionnaire. Respondents are asked to select from an extensive list of educational topics those areas on which they desired: (1) information, (2) group activities, or (3) confidential personal assistance. Some examples of the educational topics include stop smoking programs, loneliness, exercise programs, career development, etc. For each of the items for which they request information, group activities, or confidential personal assistance, the computer has provided the following: 1) courses for academic credit and the number of credit hours offered; 2) professionals on campus who have expertise in the particular area, with their phone numbers; 3) media resources such as movies, tapes, books, magazines, or pamphlets; and 4) community agencies that have expertise in the particular area. The topics for the personal growth section will appear on each respondent's printout in the following form: 80 PERSONAL GROWTH SECTION - AUTOMATED REFERRAL The following resources have been found helpful by UW-SP students in learning about the following tOpics: Stop Smoking Programs A. AS Courses for Academic Credit Health 104 Current Health Issues, 2 credits. Pswmokmylflo Psychoactive Drugs and Behaviors, 3 credits. Physical Jogging, 1 credit. Education People Within the University Staff of Counseling 346-3553 Staff of Health Center 346-4646 Media Pamphlets/brochures - Student Health Center Tape - Smoking Modification - Elsenroth and Hettler Cassette - Joys of Smoking (2) - Student Affairs Books - ILearning to Live Without Cigarettes, Allen, Angermann, and Fackler. - Personal Health Appraisal, Sorochan. Community Resources YMCA - stop smoking program 346-1770 River Pines - live-in stop smoking programs 346-1880 Portage County Council on Alcohol and Drug Abuse 346-4611 can be noted on the above sample printout, stemming from this student's request for information on smoking cessation, the computer provided him/her with an extensive 81 list of resources available for consultation on this particular topic. Similarly, if a respondent requested information, group activities, or confidential personal assistance (n1 any of the educational topics, his/her printout would include a referral list for each of those topics (p. 7-8). Section III: Risk of Death Based on actuarial data from the United States government and the book How to Practice Prospective Medicine by Robins and Hall (1970), this section can help the respondents determine their chances of death over the next ten years. The subsection Life Expectancy Results provides :the respondent with three types of information: 1) respondents can determine the average number of remaining years that people of their age, race, and gender can expect to live: 2) based on respondent's answers concerning their lifestyles, heredity, and medical history, respondents can determine their expected years of remaining life; and 3) final information provided is the respondent's achievable expected years of remaining life. This section will appear in a printout in the form below. L— . 82 LIFE EXPECTANCY RESULTS SAMPLE 25 30 35 40 50 55 6O 1. Average years of remaining 53 * * * * * * * life in your sex, age, race group. 2. Your expected years of 38 * * * * remaining life based on your answers 3. You can achieve this 56 * * * * * * * * expected years of remaining life The next subsection - Major Hazards to the Respondent, provides part of the printout and is intended to: 1) make them aware of the leading causes of death for their particular age, race, and sex group; 2) show them a comparison of their probability of a particular cause of death as compared to others of their age, race, and sex (labeled "average"), and to show them the predicted chance they could possibly achieve (labeled "achievable"); and 3) to identify for them the associated risk factors which contribute to particular causes of death. 83 This subsection appears on a printout in this form: Major Hazards to You 10 Yr. Deaths Associated Rank Hazard (per 100,000 Risk Factors 1 Motor vehicle accidents: Average 815 Your 4238 Riding with Achievable 489 someone who 11a.s k>eeen drinking From this sample, you can interpret that motor vehicle accidents are the greatest potential hazard to this person. Using actuarial tables, a predicted 815 people out of every 100,000 will die the next ten years from his/her age, race, and sex group because of motor vehicle accidents. This person's predicted chance is 4238; yet, if he/she changed the associated risk factors, drinking habits, seat belt habits, and riding with someone who has been drinking, an achievable score of 489 could be attained. (p. 6) Section IV: Medical Alert Section This last section of the Lifestyle Assessment Questionnaire is designed to provide respondents with information whihc they can utilize as a medical history enui health status chart. This section, which could also be used as part of a medical chart iJlaa health care system, addresses the following specific areas: a current pmoblem list, current medications, a list of suggested lifestyle improvement needs, a list of allergies, a resolved problem list, and a list of immunizations. This section will appear on a printout in the following form: 84 Medical Alert Section Current Problem List Family history of heart disease Patient has had major surgery Current TB test No reaction to TB (p. 7) Research Questions Research questions pertinent to the study were posed to explore health programming whose purpose is to improve the health practices of college students. In an effort to ascertain programming achievements, an examination of inter— and intra-programming measures were taken. Questions were as follows: 1) 2) 3) Do students in a university which has implemented a comprehensive wellness program show significantly higher scores on a wellness inventory than students from the comparative institution who responded to the same inventory? Do the students at the University of Wisconsin- Stevens Point show significant gains over their entry level testing scores on the assessment instrument as compared to assessment scores taken at a later date? In relation to gender ratio, the following question has significance for the study: Are there significant gender differences among the 85 scores of the respondents to the assessment instrument? To examine the above research questions, it was the author's intention to calculate group scores for both institutions auui combined individual gain scores for the University of Wisconsin-Stevens Point, thereby providing comparability data between the group gain scores of both instUnmjons and exposure data at the University of Wisconsin-Stevens Point in order to determine the outcomes of the following hypotheses. Hypotheses and Subscale Variables Hypothesis I There will be a difference on the wellness inventory scores depending on respondents' gender. Across both institutions, women will score higher than men on measures as indicated on the wellness instrument. Rationale Through socialization, many men maintain unrealistic, virile attitudes. Therefore, they will not adequately self-report on the wellness instrument, thus scoring lower than women who maintain more realistic assessments of health indicators. Variables The dependent subscale variables will be the respondent score on the wellness instrument. The independent subscale variable will be the gender of the respondents. 86 Hypothesis II There will In; a difference on the wellness inventory scores between the University of Wisconsin-Stevens Point and the comparative institution. Rationale Due to the effects of wellness programming the University of Wisconsin-Stevens Point respondents will be more knowledgeable of concepts, strategies, techniques, and philosophies, thus benefiting in attitudes, knowledge, and orientation of health care and health values and, therefore, producing higher scores. Subscale Variables The dependent subscale variable will be scored on the wellness inventory. The independent subscale variables will be wellness programming efforts. Hypothesis III There will be a difference on the wellness inventory scores depending on the respondent's age. Scores will be significantly higher among the older respondents. Rationale Due to the effects of maturation, the respondents from both institutrons will be more knowledgable of concepts, strategies, techniques, and philosophies thus benefiting in attitudes, knowledge, and orientation of health care, and health values and, therefore, producing higher scores. %— _,__*‘ .. . ___L_ ‘.A_ 87 Subscale Variables The dependent subscale variables will be scores on the Wellness inventory. The independent subscale variable will be age of the respondents. Hypothesis IV There will 1x3 a difference on the wellness inventory scores over time. Scores will be significantly higher after exposure to wellness programming efforts. Rationale With an introduction and varied instruction in wellness medicine, students with lengthened exposure to wellness programming will be more knowledgeable of concepts, strategies, techniques, and philosophies, thus benefiting in attitudes, knowledge, and cmientation of health and health values, than those with less exposure. Subscale Variables The dependent subscale variables will be scores on the wellness instrument. The independent subscale variables will be respondents' lengths of exposure to wellness programming. Statistical Method Used in the Analysis In an attempt to produce a detailed analysis of data, and due to the number of subscale variables to be studied, an analysis of variance (ANOVA) was used; 88 specifically, a three-way ANOVA using institution, gender and age; and a one-way repeated measures ANOVA using gender as between subject and time as within subject. The main effects on the independent subscale variables were also tested. A statistical hypothesis was tested using a .05 level of significance. Reliability and Validity The following are the reliability coefficients and percent matches for the Lifestyle Assessment Questionnaire with N equaling 39: EL“ Wellness Inventory Section .76 Subsections: Physical Exercise .77 Physical Nutritional .74 Physical Self-Care .60 Physical-Vehicle Safety .59 Physical-Drug Usage .57 Social—Environmental .65 Emotional Awareness and Acceptance .87 Emotional Management .79 Intellectual .86 Occupational .58 Spiritual .77 Risk of Death Section Percent Matches 89.92 Medical Alert Section Percent Matches 91.06 Personal Growth Section Percent Matches 86.60 (Elsenroth, 1982) 89 Limitations To place the analysis in proper perspective, a list of limitations is examined. The following were revealed at the time of the analysis and are directly related. These limitations are in addition to the delimitation section presented in Chapter I. 1) 2) 3) The response rate of those involved in this study at the University of Wisconsin-Stevens Point was above average while the comparative institution reported just above average. The non-responses were attributable to the reality that summer academic sessions are not the ideal time to ask students to complete a lengthy questionnaire. Students are overburdened with "condensed" classes and more times than not, undergraduate students (from which this sample was drawn) are forced into summer school to pick up remaining classes needed to fulfill graduate requirements or to make adjustments to re-designed programs. The lengtjl of the assessment instrument posed a problem for some individuals as 286 questions were a "bit too much" to warrant involvement. By the very nature of subject of this study, many personal questions were asked, i.e., drug usage, communicable diseases, sexual practices. Some felt the questions were invasive and were in 90 violation of their best interest and posed confidentiality problems. 4) Sampling procedure was redesigned due to logistical constraints imposed by the author. As a result the ”N" is disproportionate as observed: 134 respondents from the University of Wisconsin- Stevens Point and 108 from the comparative institution. 5) The response rate to some of the questions was low enough to warrant the exclusion of Subscale Variable ll, Spirituality. This subscale was disregarded in the one-way repeated measure (ANOVA) only. 8mm A sample of 400 university students from the University of Wisconsin-Stevens Point and 200 students from the comparative institution were asked to respond to questions on.tflue Life Assessment Questionnaire (LAQ) which was designed to measure health attitudes and practices. 'The response rates were 134 and 108 respectively. Using an Analysis of Variance (ANOVA), a three-way ANOVA using institution, gender, and age was employed, as well as a one-way repeated measure ANOVA using gender as 91 between subject and time as within subject.2 Each of the hypothesis was tested at the .05 level of significance. 2For further explanation of statistical procedures, refer to Campbell, David and Julian Stanley. Experimental and Quasi Experimental Design for Research. CHAPTER IV ANALYSIS, RESULTS AND INTERPRETATION OF THE DATA Introduction The results of the analysis of the data is presented herewith. A summary table (4.1) is provided followed by presentation of the data. Included is the two-way and three-way interaction data and accompanying figures and tables (Figures 4.1 - 4.4 and Tables 4.2 - 4.5). Next, a report of the hypothesis immediately proceeds the appro; priate Table of Means (Tables 4.6 - 4.10). The concluding section will be a discussion of the analysis and its findings. Statistical Results and Summary Data For detailed analysis of the data from this study, an analysis of variance (ANOVA) method was used. A three-way ANOVA using institution, gender and age, and a one-way repeated measure ANOVA using gender as between subject and time as within subject were utilized.1 Statistical hypothesis were tested using a .05 level of significance. Summary paragraphs of the results are provided with calculations of the ANOVA included. Other table entries are provided when deemed necessary in reporting the data. Keys are displayed with respect to their specific tables. 1For further explanation of statistical procedures refer to Campbell, David and Julian Stanley. Experimental and Quasi Experimental Research. ‘ 92 93 Ikeeafiathxofthelxma Table 4.1 Cross-Sectional Analyeis Subscales Gender Institution Age. Interaction 1. Exercise - * - - 2. IkflritRXI - * - - 3. SelfeCare * * - - 4. ‘Vehicle Safety * * - - 5. Drug Use - * - GAI *** 6. lhndrommxmal - - - (H:** 7. Enotkmal .mfinemees - - - (HI** 8. Emfiiarfl bfimamment - - GI‘” 9. Inuelhxtnal - 10. Occupational - 11. Spiritual * *I-l I I * significant at .05 level ** .05 significant two~way interaction between gender (G) and institution (I) *** .05 significant threedway interaction between Gender (G) Age (A) and Institution (I) - Ir>sflfififiamme In tflua crossfisectional data, significance differences were found between gender on three out of eleven subscales measures. Women outscored men on three of the dependent subscales, each reporting significance at time .05 level (Tables 4.1 and 4.6). Institutions also were significant on seven of the dependent subscales. The University of Wisconsin-Stevens Point reported significantly higher scores on all seven dependent subscales at the .05 level (Tables 4.1 and 4.7). 94 A three-way interaction (on gender, age, and institution) was significant on one subscale (Figures 4.1 and Table 4.2) and the two-way interaction gender and institution was significant for 3 subscales (Figures 4.2, 4.3, and 4.4; Tables 4.3, 4.4, and 4.5) The longitudinal data report after exposure, respondents scored significantly higher on eight out of ten independent variables (Table 4.9). Gender influence show women scored significantly higher than men after one year exposure on one dependent subscale measure (Table 4.9). The first measure reports a significance with regards to gender with women scoring higher on three subscales (Table 4.9). Age I: 18—19 years; Age II: 20—24 years; Age III: 25 or older Variable 5, DRUG USE Men Women Men Women UNIVERSITY OF WISCONSIN COMPARATIVE STEVENS POINT INSTITUTION Figure 4.1 Three-Way Interaction Between Independent Variables Gender, Institution and Age on Variable 5, Drug Use 95 Table 4.2 Three-Way Interaction Between Independent Variables Gender, Institution and Age on Subscale Variable 5, Drug Use University of Wisconsin Stevens Point Standard Gender Age N Mean Deviation Men I 17 4.6 .40768 II 16 4.7 .21361 III 9 4.3 .44631 1 Women ‘ fl ‘ I 27 4.5 .65257 j‘ II 28 4.6 .45077 ‘8‘ III 38 4.8 .19303 Comparative University Standard Gender Age N_ Mean Deviation Men I 2 4.7 .16318 II 13 4.2 .99896 III 19 4.5 .38822 Women I 17 4.3 .79837 II 22 4.6 .37516 III 18 4.5 .44251 Variable 6, ENVIRONMENTAL SCORES 4.4 96 Women Men Women UNIVERSITY OF WISCONSIN STEVENS POINT Figure 4.2 COMPARATIVE INSTITUTION Two-way Interaction Between Independent Variables Gender and Institution on Subscale Variable 6, Environment Table 4.3 Two-Way Interaction Between Independent Variables Gender, and Inetitution on Subscale Variable 6, EnVifonment Gender Men Women Gender Men Women University of Wisconsin Stevens Point Pi 42 86 Comparative University 11 4O 60 Standard Deviation .57396 .47837 Standard Deviation .60093 .57495 97 4.6- - Men Variable 7\, 4,4. EMOTIONAL _ Women Women AWARENESS 4.2_ Men SCORES 4.0. 3.8[ 3.A UNIVERSITY OF WISCONSIN COMPARATIVE STEVENS POINT INSTITUTION Figure 4.3 Two-way Interaction Between Independent Variables Gender and Institution on Subscale Variable 7, Emotional Awareness Table 4.4 Two-Way Interaction Between Inde endent Variables Gender, and Institution on Subscale VariabIe 7, Emotional Awareness University of Wisconsin Stevens Point Standard Gender N Mean Deviation Men 42 4.27 .61223 Women 40 4.37 .42706 Comparative University Standard Gender N Mean Deviation Men 85 4.52 .42209 Women 67 4.31 .46954 Variable 8, EMOTIONAL MANAGEMENT SCORES 98 Women Women UNIVERSITY OF WISCONSIN STEVENS POINT Figure 4.4 INSTITUTION Two-way Interaction Between Independent Variables Gender and Institution on Subscale Variable 8, Table 4.5 Emotional Management Two-Way Interaction Between Independent Yariables Gender, and Institution on Subscale Variable 8, Emotional Management Gender Men Women Gender Men" Women University of Wisconsin 11 42 39 Comparative University Stevens Point Mean 4.07 4.16 Mean 4.26 4.14 Standard Deviation .63938 .36932 Standard Deviation .50841 .42174 99 HypothesisTesting Hypothesis I There will be a main effect on the Wellness Inventory scores depending on the respondents gender. Across both institutions, women will score higher than men on the eleven subscales as indicated on the wellness instrument: H1 Women will score higher than men on subscale Variable 1, Exercise. H2 Women will score higher than men on subscale Variable 2, Nutrition. H3 Women will score higher than men on subscale Variable 3, Self-Care. H4 Women will score higher than men on subscale Variable 4, Vehicle Safety. H5 Women will score higher than men on subscale Variable 5, Drug Use. H6 Women will score higher than men on subscale Variable 6, Environment. H7 Women will score higher than men on subscale Variable 7, Emotional Awareness. H8 Women will score higher than men on subscale Variable 8, Emotional Management. H9 Women will score higher than men on subscale Variable 9, Intellectual. H10 H11 Three hypotheses were significant at the 100 Women will score higher than men on subscale Variable 10, Occupational. Women will score higher than men on subscale Variable 11, Spiritual. They were H3, H4, and H11 (Table 4.6). Hypothesis II There will be a significant difference on the wellness inVentory scores between the University of Wisconsin-Stevens Point and the comparative institution. H1 H2 H3 H4 H5 University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 1, Exercise. University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 2, Nutrition. University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 3, Self-Care. University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 4, Vehicle Safety. University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 5, Drug Use. .05 level. score score score score score Ho>oH mo. OLD um ucmofimacmfim mwuoom camewm ««« ...nmao. mammv. 0.4 Hmfl mmmmw. m.m Hm Hasnfluhmm .HH mmHH. osomm. N.v man mmoow. H.v as Hmcofinmdsooo .oa «moo. ooovv. m.m mmH momve. G.m mm HmsuowafioucH .m mmma. sammm. «.4 mma Hmosm. H.v Hm namemmmcmz HMCOfldOF—W am ammo. mmmom. v.4 «ma mmmsm. m.v mm mmmcwumzc Hmcofiuoem .s lOl oHvH. madam. H.v mmH mamvm. o.v Nm DCOECOHH>Cm .w NHHQ. oammm. m.v mmH mahmm. m.v mm mm: mDHO .m «««mmoo. mmomm. m.v mmH hmmvm. H.v Nm wuwwmm OHUH£O> .¢ fircoco. mmvam. w.m mmd V hmmov. m.m mm OHMUIMHOW .m thm. vammv. m.m mmH momhv. h.m mm :OHufluusz .N mmho. ¢voom. v.m NmH wmmhv. v.m mm meUmem .H moflm> :oflumfl>wo cow: (ml EOHpmfl>mo :mwz m memz oumocmum oumocmum OHQMHHO> OHMOmnom mwfimeom wwwmm mfimfiucoumwmaa umocwo o.v wfinme H6 H7 H8 H9 H10 H11 102 University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 6, Environment. University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 7, Emotional Awareness. University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 8, Emotional Management. University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 9, Intellectual. University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 10, Occupational. University of Wisconsin-Stevens Point will higher than the comparative institution on subscale Variable 11, Spiritual. score score score score score score Seven hypothesis were significant at the .05 level. 103 HO>OH mo. map um ucmoflwficmflm monoum unfiom mcw>wumchmGOOmfl3 mo hpflmum>fiso mama. 4..Hmmon ...mmao meow. NNoH. oava. ...ssaon ...mvao onm> hamom. movmm. ommwv. ovmwfl. ooaam. hmHHm. Hmhov. mmawm. mvwvm. vwmmv. momhv. coflumfl>wo onmocmnm :ofluouflumcH w>flumumoeoo woa aa moa boa moa mma woa boa moa moa boa mmmmm. mvomv. mvamv. mhhmm. oommm. mamvm. mmoom. mmwvm. mmmvm. memv. Nthv. :oflumfl>wo cnmwcmum o N m H V O <‘ V'MV‘V' 050 O V'Q‘V“ 00300 O mmm C002 NMH hNH mma MMH NMH mma mma vma vma vma «ma usaom wco>mum «« Hmsufiuwom Hmcofiummsooo HmsuomfifimucH acmewmmcmz Hmcofluoem mmwcwumzm Hmcofiuoem ucwecoufi>cm ow: msuo Summmm oHoficw> oncolwamm coHuflHuoz wwfiouwxm * .HH .OH .m I HNMV‘ anm mfimo camcoomflz mo wuflmum>fi:: h.v magma mfimflucwwmwMHo :oHuoufiumcH OEmz hum> meow Hypothesis III 104 There will be a difference on the wellness inventory scores depending on the respondents age. Scores will be significantly higher H1 Scores will on subscale H2 Scores will on subscale H3 Scores will on subscale H4 Scores will on subscale H5 Scores will on subscale H5 Scores will on subscale H7 Scores will on subscale H8 Scores will on subscale H9 Scores will on subscale H10 Scores will on subscale among the older respondents. be higher among the older respondents Variable 1, Exercise. be higher among the older respondents Variable 2, Nutrition. be higher among the older respondents Variable 3, Self-Care. be higher among the older respondents Variable 4, Vehicle Safety. be higher among the older respondents Variable 5, Drug Use. be higher among the older respondents Variable 6, Environment. be higher among the older respondents Variable 7, Emotional Awareness. be higher among the older respondents Variable 8, Emotional Management. be higher among the older respondents Variable 9, Intellectual. be higher among the older respondents Variable 10, Occupational. Tina ‘ H11 105 Scores will be higher among the older respondents on subscale Variable 11, Spiritual. No significance at the .05 level was reported with respect to age (Table 4.8). Hypothesis IV There will be a difference on the wellness inventory scores over time. Scores will be significantly higher after exposure to wellness programming efforts. H1 H2 H3 H4 H5 H6 H7 H8 Scores will be higher on the repeated measures subscale Variable 1, Exercise. Scores will be higher on the repeated measures subscale Variable 2, Nutrition. Scores will be higher on the repeated measures subscale Variable 3, Self-Care. Scores will be higher on the repeated measures subscale Variable 4, Vehicle Safety. Scores will be higher on the repeated measures subscale Variable 5, Drug Use. Scores will be higher on the repeated measures subscale Variable 6, Environment. Scores will be higher on the repeated measures subscale Variable 7, Emotional Awareness. Scores will be higher on the repeated measures subscale Variable 8, Emotional Management. on on on on on 106 gouge no mm "HHH «ma oHo whom» omuom "HH one go mumom mHImH "H om< "mom msom. mamos. o.v mo Hooas. o.v om emsss. o.¢ mo Hmoufluaom .HH oamm. momms. H.v mo mawmm. N.v mm wovom. H.v mo HMCOHuwmoooo .oa mmom. ommso. s.m so movoo. m.m Hm Nssms. s.m mo HMDDOOHHODGH .a mwem. Nvomm. H.v om Haosv. N.v Hm mmmwm. v.v mo unwewmmgmz Hmam. vvmmm. m.v mm mmasv. N.v Hm wmmwm. v.v mm mmmcwumzfi oooo. assoo. H.o so mmoso. H.o Hm HaHNo. 0.4 mo namecouascm .o ommo. Hommm. o.o so osomm. o.o Hm oommo. o.o mo mm: mane .m mmmm. ssoam. m.o so mmmmm. N.o mm mmmmo. ~.o mo suommm maoanm> .o ammo. smmoo. o.m so ommoo. s.m mm momoo. s.m mo oumoanmm .m mgmo. oomms. s.m so Namao. m.m mm oooos. s.m mo :ofinanusz .m sosm. mmmos. o.m so osmmo. m.m Hm oaooo. o.m mo monouwxm .H msgm> schoon>mo com: .m coflnma>wo com: .m coflumflsmo com: .m memz m unmozmum oumoqmum onmocmum m~nmanm> onomnsm HHH mm< HH mam H mm< mamflucmnwooflo mm< m.v OHQMB 107 H9 Scores will be higher on the repeated measures on subscale Variable 9, Intellectual. H10 Scores will be higher on the repeated measures on subscale Variable 10, Occupational. Because of a low response rate on subscale Variable 11, Spirituality, it was deleted from the analysis of Hypothesis IV. The remaining ten variables were incorporated into the design. Eight dependent subscales report a significance at the .l ‘11-}... . .. .05 level showing higher scores on the repeated measure (R) (exposure). They were H1, H2, H5, H6, H7, H8, H9, H10 (Table 4.9). Gender is statistically significant on the repeated measure on one subscale; it was H5 (Table 4.9).2 2Table 4.10 has been included to show that age (maturation) has no statistical relevancy to gained scores as reported with the significant data. 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H.0 H0 HOHNO. 0.0 00000. 0.0 H0 000N0. 0.0 00000. N.0 N0 0NON0. N.0 00000. 0.0 N0 00000. 0.0 NHOH0. 0.0 N0 00000. 0.0 00000. 0.0 H0 0H000. 0.0 £03355 :mm: m coHumH>mo goo: UHMUmem UHwflcmum HH 000 H 000 "H: mom "HH 000 "H 004 “mom mo Hmfiflflm .3 mo 88.3888 .3 mo $38233 .m 00 Hams—003m: Hacofloam .m 00 mmOfiOHflsfi HgOflHQs—m .0 mo 22.8095 .o mo 9.5 03a .m mo 53mm 2020, .0 mo annouflmm .m mo 800052 .N 00 wwflouwxmm .H z 282 $93.5, wfiflomfldm 117 Discussion of the Analysis In analyzing the data, certain trends are observed with respect to specific subscale variables that either prove significant at the .05 level or at least report positive but not significant results. A significant difference exists between men and women respondents with women reporting higher scores on the majority of the subscale variables. Similarly, respondents from the University of Wisconsin-Stevens Point report overall higher scores. Even though age differences were not significant, more respondents fall into the age II category and program exposure has a significance on wellness scores. Specifically, the data reveals the following: A three-way interaction (gender, age and institution) reported on subscale Variable 5, Drug Use. A two-way interaction (gender and institution) reported on subscale Variable 6, Environment; subscale Variable 7, Emotional Awareness; and subscale Variable 8, Emotional Management. Gender significance on main effect report women scoring significantly higher than men on subscale Variable 3, Self-Care; subscale Variable 4, Vehicle Safety; and subscale Variable 11, Spirituality. Women also report higher scores at a later age than men. ,g ‘3‘ 118 Institution distribution report the University of Wisconsin-Stevens Point respondents scoring significantly higher on subscale Variable 1, Exercise; subscale Variable 2, Nutrition; subscale Variable 3, Self-Care; subscale Variable 4, Vehicle Safety; subscale Variable 5, Drug Use; subscale Variable 9, Intellectual; and subscale Variable 10, Occupational. Longitudinal data from the University of Wisconsin-Stevens Point present a positive trend on the independent variable, exposure. As ascertained through the one-way repeated measure ANOVA. Respondents scored significantly higher, over time, on subscale Variable 1, Exercise; subscale Variable 2, Nutrition; subscale Variable 5, Drug Use; subscale Variable 6, Environment; subscale Variable 7, Emotional Awareness; subscale Variable 8, Emotional Management; subscale Variable 9, Intellectual; and subscale Variable 10, Occupational. An interaction between gender and the repeated measure shows significance on subscale Variable 5, Drug Use; and the first measure reports a significance with regards to gender with women scoring higher on subscale Variable 6, Environment; subscale Variable 9, Intellectual; and subscale Variable 10, Occupational. Considering the above, the data clearly demonstrate a relationship with respect to certain independent variables. 119 Summary This chapter has presented the findings of this research study; a general overview of the data findings immediatelyprecededandrwpothesistesting,withcalculations of the ANOVA included. Accompanied pertinent figures and tables were displayed when appropriate. A discussion of the analysis follows with attention to specifying findings related to the independent variables; gender, age, institution, and program exposure. CHAPTER V SUMMARY, CONCLUSION, DISCUSSION, IMPLICATIONS “COMMENDATIONS FOR FURTHER RESEARCH AND FINAL REFLECTIONS Purpese of the Study The purpose of this study was to compare and analyze the attitudes, knowledge, and orientation of students from two separate institutions of higher education which are similar in selected variables, but differ in their availability of wellness programming. One institution provides a continuing and concerted effort in wellness programming; the other has no focused effort in wellness programming. This descriptive analysis has compared six dimensions of wellness: intellectual, emotional, physical, social, occupational, and spiritual among students from both institutions. Review of the Literature A comprehensive review of the literature suggested that a growing concern with stress and its ramifications on ill health combined with the threat of iatrogenic disease has resulted in tremendous attention to alternative approaches to health and health care. As recognized by Fletcher, the 1974 Canadian Report, "A New Perspective on the Health of Canadians," acknowledges that a person's health is influenced more by his/her environment, 120 121 lifestyle, and heredity than by medical care. In the United States, the publication Healthy People encourages "a second public health revolution to attack the killer diseases of civilization" (Fletcher, 1983, p. 89). It has been postulated in contemporary literature that consumers turn away from orthodox western medicine, which often is perceived as disabling instead of rehabilitating, and return to the original forms as first described by Hippocrates: "A physician's studies should include a consideration of what is beneficial in a patient's regimen while he (sic) is yet in health; not focus primarily on disease" (Fletcher, p. 87). Theoretical considerations vary greatly as to an appropriate measure of health and health care; however, a general consensus of the urgent need to develop alternatives for health and health care delivery has been identified. Contradicting orientations in the various schools of medicine are a complication in the development and acceptability of alternatives (Gage, 1980). Many argue that behavioral indicators are measured against non-biological evidence; however, a highly consistent argument has emerged as the need for a well-integrated paradigm of concepts, strategies, and a need for action to alternative approaches to well-being and health maintenance (Cousins, 1979; Gage, 1980; Illich, 1982; Pelletier, 1982). 122 In an effort to empirically reference alternative approaches to health, health maintenance, and health care delivery, a reasonable population must be statistically assessed to measure the effects of wellness (alternative) programming. The university system was chosen to provide this needed population because of student developmental characteristics and the vulnerability of university students, in addition to recognizing the missions of institutions of higher education toward programming efforts to meet the needs and changes of the lifestyles of their constituents. To articulate the impetus of this research effort, two questions were formulated: 1) Can one modify the behaviors of college students through an integrated wellness program and thereby increase both good health practices and physical conditioning, which will ultimately enhance management and coping skills within this population? 2) Can a wellness needs assessment be used as a satisfactory basis for stimulating a preventive maintenance system to counter the present disease-oriented medical care system? According to recent research and clinical practice, these are possibilities, and reorientation from crisis- 123 disease-oriented medicine to preventative health maintenance is underway. (Pelletier, 1982) The contribution of this study may possibly assist in answering these questions. Changing one's lifestyle to incorporate healthful living is a social as well as a personal responsibility. It is contended that the promotion of high level wellness within college and university systems could improve health and yield positive health indicators as determined by credible biological and behavioral assessments. Design of the Study The instrument from which the data for this study was obtained is the Lifestyle Assessment Questionnaire (LAQ), second edition, and is the assessment tool used by the University of Wisconsin-Stevens Point to measure high—level wellness among its students. The LAQ was developed in 1976 and has undergone continuous revision for the past three years. Various facets of the evaluation have been done by a committee of the Student Life Division at the University. When they deemed necessary, investigations were undertaken through suggestions from LAQ respondents and professionals throughout the country. This instrument was administered by the researcher to each separate population under investigation. 124 .A combined total of 400 students from the University of Wisconsin-Stevens Point were sampled with 134 students responding. From the comparative institution, 200 students were sampled with 108 responding to the Life Assessment Questionnaire. A three-way ANOVA using institution, gender and age was employed and a one-way ANOVA repeated measure using gender as between subject and time as within subject was also utilized. The statistical hypothesis was tested using a .05 level of significance. Using these analyses, independent subscale variables gender, institution, age and program exposure were measured with respect to the eleven dependent subscale variables. Findings of the Study To summarize, the results of the statistical analysis are as follows: 1) A difference existed between men and women with women scoring higher than men on ten subscale variables. A statistically significant difference existed on three of the subscale variables. 2) The University of Wisconsin-Stevens Point reported overall higher scores on all eleven subscale variables. A significant difference was reported on seven of the variables. 3) 4) 5) 6) 125 Even though age difference was not significant, more of the respondents fell into the age II category. A three-way interaction of age, gender, and institution was reported significant. Three two-way interactions of gender and institution were reported significant; and, Longitudinal data presented a significant difference after exposure on eight subscale variables and this repeated measure combined with the influence of gender report significance on one subscale variable. Conclusions and Discussion Based on the findings of this study and with respect to the population surveyed, the following conclusions can be drawn: 1) A statistical significant relationship existed between gender with women scoring higher than men (n1 three dependent subscale variables. Even though the remaining variables did not report a significance, a positive trend existed in reference to the female gender on their scores on the wellness assessment. The male respondents scored higher than their counterparts (n1 one subscale variable. This apparently suggests 126 women, either through achieved and/or acquired patterns, reflected more interest in personal health, health care and related areas of concern. These scores could also suggest that women report more honestly than men on issues relating to personal health and health care. 2) As reported in the longitudinal analysis, a statistical relationship existed with respect.tx> the repeated measure (exposure) to the wellness curriculum. This further corroborates that knowledge about wellness can be learned and; furthermore, the more time spent learning about wellness, the more knowledge an individual will gain and retain. 3) A statistically significant difference existed between the University of Wisconsin-Stevens Point and the comparative institution on the majority of the dependent subscale variables. These results imply that a wellness curriculum within an institution of higher education can produce significant learning. Implications and Recommendations for Further Research This study provides some statistical evidence that implies that the university system is a potential resource 127 center from which wellness instruction can operate successfullyn. The difference between the health and health lifestyles profiles of the University of Wisconsin- Stevens Point and the comparative institutional groups is recognizably different and statistically significant on the majority of the measures. Given the purpose of this resource study, this is of particular interest. Areas for further investigation are as follows: 1) The data clearly show that wellness programming works (for whatever the reason) and fulfills its intention, as reflected in the scores on all of the eleven measures as they pertain to Hypothesis II. This was further corroborated by the factors of repeated measure (R) and repeated measure tar gender (RS). When observing this significance, one could consider the maturation effect. However, this independent subscale variable does not prove significant as a main effect within its separate analysis. Because of this, and the obvious surfacing of traits, it would seem appropriate to investigate further diffusion efforts within the independent subscale variable, institution. Isolating traits as to their influence is essential. Specifics need to be researched which will ultimately aid in a more 2) 128 thorough and credible assessment of programming efforts and development. The two institutions of higher education under investigation in this study are located in the mid-western region of the United States. Precautions have been taken to identify institutions similar in demographic characteristics; however, geographical considerations must be questioned as to the appropriateness of inferences relative to other university systems operating within other geographical regions of this country. Generalization of the results to any other population would be appropriate only to the degree that they are similar to the sample. Assuming the analysis is correct, investigation is warranted to identify precipitating factors inherent to geographical location that might have influenced the significant scores. As mentioned in Chapter II, "The Review of Literature," medical geography plays a decisive role in determining health and health practices of individuals. Therefore, a valid interpretation of geographical relevancy will yield further research inquiry and 129 investigation. Precipitating factors needing further investigation are outlined below: a) b) C) Economic factors are known to have a determining influence on health care issues (Fuch, 1974; Illich, 1976; Kennedy, 1974; Sidel and Sidel, 1984; Stevens, 1976). Economic factors may have been the most powerful influence on hOw these students were taught to perceive reliable health care and health status. The economy persuades the medical decision maker of what kind of information he or she ought to have and how to arrange that information in terms of the relative value of various courses of actions (Fuch, 1974), therefore; economic factors need to be considered. Political orientation of the area suggests perhaps compelling difference in the way an individual perceives his or her responsibility on health issues (Kennedy, 1974) including direct involvement in social action on this issue. Religious influence, whether deterministn: or anti-deterministic also may have had a direct bearing. 3) 130 d) Parental background.cn: socio-economic status and educational achievement (or more importantly non-achievement) are known to be correlates of health practices. Pursuing an inquiry into these indices to determine the significance of their influence onto the programmed institution would be of interest. e) The epidemiology of disease (if any) recognized within this region, needs to be explored, and; f) The powerful influence of an international medical research and training facility on their sister campus in Madison should also be considered as an influencing variable. The wellness lifestyle climate appears influential on the University of Wisconsin-Stevens Point institution. It is assumed its faculty and staff are wellness oriented, either by nature or by university influence. To deny this would be absurd, but to weigh its overall influence is a. question of interest. Are programming efforts through orthodox curriculum, i.e. instruction, in-service, written literature, and audio visuals, responsible for the significant scores, or is it the explosive techniques of total exposure 4) 131 through alternative clinical services, availability of vegetarian meals and related nutritional alternatives, dorm related activity, completion of the Life Assessment Questionnaire, and influential profiles of health professionals linked to the institution, and various alternative health education related resources, etc.? Determining the relative impact of educational techniques and strategies would be beneficial to curriculum experts, specifically those specializing in health education. Examining this database wouLd be a good starting point for those particularly interested in wellness medicine and non-formal education. It has been empirically proven that stress-related illness occurs after the stress-related incident when the autonomic and parasympathetic nervous systems have been engaged in constant activity resulting in patterns of neurophysiological alterations specific to particular disease (Pelletier, 1977). This reaction could be due to identifiable (or unidentifiable) stress but it does not discriminate between the ages. As a matter of fact, identifiable or unidentified, unabated prolonged stress has a damaging effect (1“ 5) 132 on one's psycho-immunological entity. This observation suggests the urgency of intervention into health care services for our younger population and this acknowledgement should reinforce societal responsibility which is also a dimensional aspect of wellness. (Given this, would it be beneficial to start programming efforts at an earlier age, possibly elementary school? Elementary school educators and curriculum specialists might find this data a starting point to investigate further programming efforts based on cognitive, affective, and developmental theories specific to children and/or adolescents. Trait characteristics keep surfacing as indices needing investigation to further attempts tn) build sound health care education and delivery. As this study shows, traits can be identified and programs developed and/or altered to meet the needs of specific populations. Just as programming efforts have been developed around mission statements of university and college health services specific to the needs and acknowledgment of their clientele, it would seem plausible to develOp programs for other 6) 133 identifiable institutional populations, i.e., community programs for the older adult, psychiatric, developmentally disabled, and/or dually-diagnosed residential aftercare programs, or programs for any economically disadvantaged population. As seen in the analysis, women score significantly higher on the majority of the dependent subscale variables than men. From a psycho-social and economic reference, it might be inferred that there are traits or characteristics, either acquired or achieved, in sex roles that are responsible for the statistical difference. Efforts to isolate these characteristics and theorize as to their causation would justify further research, especially in light of the contemporary issues of sex roles and related areas of concern. The women's health movement attempts to demystify women's bodies, and stress the urgent need for women to understand their bodies and become knowledgable of competent care in the areas of health and health care delivery (Chesler, 1972; Corea, 1977; Fee, 1977; Reeves, 1971). The movement recognizes that the practice of medicine requires personal characteristics compatible with 134 those traditionally ascribed to women. The movement attempts to feminize healing by incorporating gentler concepts, and to diminiSh the warrior-doctor model of traditional medicine and return to the gentle-healer set by their medical foremothers (Corea, 1977). The movement stresses responsibility by the women for themselves. This is essential to maintain health and prevent disease, it reCognizes the body as a whole system, capable of healing itself. This movement holds the psycho-immunological system in esteem and it resists intrusion, invasion and all unwanted anui unnecessary manipulations (Chesler, 1972; Corea, 1977; Fee, 1977; Holt and Weber, 1981; Reeves, 1971). The women's health movement proclaims the same message as the wellness movement. It shares an awareness of the natural regenerative powers of the body, and women's responsibility for their own health by pursuing knowledge of competent care based on the realities of her own unique psycho-immunological entity in the face of socio-political opposition. bhnfli like wellness medicine and its practitioners, the women's health movement takes a stand against traditional 135 medical orientation and cites the urgent need for lifesaving change. Given this, further investigation is needed to explore the following areas of probable causation: a) b) given the feminist attempts to represent women more proportionately in the hierarchy of the medical profession and therefore improve the nature of the patient-doctor relationship (Fee, 1977), one must deliberate on the possibility of the University of 'Wisconsin-Stevens Point employing a greater percentage of female health professionals in the upper strata of its wellness oriented health services. And if there is a considerable difference, is it statistically significant enough to warrant the exclusion of random chance and therefore yield a reliable research finding? Another possibility of trait causation is exposure to organized feminist activity - be it literature, self-help groups, educational programs, etc. at the University of Wisconsin-Stevens Point as compared to the comparative institution. (unald the statistical significance of the analysis be 136 due partially to such exposure? If this is so, then the ability of the women's movement to diffuse information needs to be further acknowledged as positive. 'N In regards to men, the questions need to be asked: could negative sociological and psychological factors influence their health care and bodily responsibility as reflected on the low Life Assessment Questionnaire score? The autonomous male, the independent strong achiever who can be counted on to be always in control is still essentially the preferred male image. Success in the working world is predicated on the repression of self and the display of a controlled, deliberate, calculated, manipulated responsiveness. To be a leader requires that one be totally goal-oriented, undistracted by personal factors, and able to tune out extraneous "noise", human or otherwise, which is unrelated to the end goal and which might impede forward motion. The man who "feels" becomes inefficient and ineffective because he gets emotionally involved and this inevitably slows him down and distracts him. His more dehumanized competitor will then surely pass hihh .. . The male hero image in our culture is reflected in the men who constitute our fantasy identification figures. Most of them share certain specific characteristics: emotional mutedness or "cool", an extremely independent style, self-containment or lack of transparency of apparent emotional vulnerability, and in general, a very narrow band of outward expressiveness. (Goldberg, 1976, pp. 42-44) Concerned sociologists, psychologists and other intereSted persons have identified the importance of 137 putting an end to this destructive journey men are subjecting themselves to. Endeavors are being made to intervene by raising the consciousness of these men; however, progress is slow. Unlike their female counterparts, men have responded poorly to attempts at consciousness-raising. Other research suggests that the carry over from self-help groups, literature and forums are minimal as the male is still in a cultural climate that has little tolerance for this emotional expressiveness (Goldberg, 1976). According to Collier and Gaiet (1956), a group of eight college men were asked by researchers to indicate their preferred heroes. As reported, they invariably preferred stories of males who were solitary, strong, independent, and in the process of activeLy striving to overcome obstacles (Goldberg, 1976). Considering the low scores by the majority of the measures for men, one must consider traits these um”: developed through the socialization process. irt has been postulated that men are pressured into and forced to live out the role of lover, husband, parent, breadwinner, strong, and silent man. This ultimately results in the inability of the psycho-immunological command and many times leads to disability and even death (Goldberg, 1976). To continue with the edict of the wellness philosophy to respect the human entity and its dimensional 138 environment, coupled with the integral component of responsibility, a call for systemic intervention is needed to redesign programming efforts to meet the needs of this population. Keeping this in mind, it must be considered that negative sociological influence has a significant bearing on such measures as emotional and physical health and thus; well-being. There is an interesting note: men respondents scored higher than women only on one measure, which was subscale Variable 1, Exercise.1 Could this be a self-fulfilling stereotype of virility and the continuation <0f a long standing male image of ”man the athlete”? The disproportionate test scores presented herein might be factors that have resulted in the "hazards of being male" Steps need to be taken to isolate traits, redesign programming efforts specifically to meet the needs of men, ultimately altering this pattern of maladaptation. Reconditioning men as to the realities of their bodiLy function and its societal misrepresentation, and their responsibility towards self and others will serve to reinforce the wellness commitment. Further research in this area should be acknowledged as a responsibility of various health care researchers and providers, and can be 1Whatever the reason for this significant score, physical fitness for health reasons could not be the main influence, especially as women were significantly higher on all the remaining variables. 139 looked upon as our defense against one of the structural breakdown of society eluded to in Chapter I. There are many dimensions inherent in wellness medicine as it acknowledges the dimensional importance of healthful living. It incorporates responsibility towards self, it recognizes the urgency of education and it adheres to the socio-political and economics demands of the century. It recognizes tine changing epidemiology of disease with its rovide fruit juices instead of fruit drinks at each meal 188 add bran to casseroles and breads have whole wheat pastries, muffins, and doughnuts available in the mornings If you have any questions about these recommendations, call me. Our food service would be an innovative, and model program if these changes were made in the board plan. cc Bud Steiner Bill Hettler John Betinis Fred Leafgren John Jury members of the Nutrition Task Force Summary of Planning Activities from the SHAC Retreat held January 25, 26, Il89 STUDENT HEALTH ADVISORY RETREAT MEETING January, 1980 and 27 at Boyd's Mason Lake Resort A modified Delphi group process procedure was used to gather ideas, rank the ideas, and estimate the requirements to implement the ideas. ' students and eighteen faculty were involved in the process. of this report will be a list in rank order of the suggestions that were made from the group and the average number of points each idea was given A rating of S was the top score possible The number after each idea when rated by the entire group. and a rating of 0 was the lowest score possible. is simply the average score that idea was given by the entire group. 1. 2. 10. ll. 12. 13. 14. Increase the positive alternatives in the vending machines on campus. List the caloric content of foods, showing the advantages to alternatives in all food service operations. Identify additional spaces and promote those spaces that now exist for quiet time so individuals would have an opportunity for reflection, meditation, and relaxation. A lifestyle development lab where individuals could assess themselves and begin to make improvements. To improve the food service operation. Advertising to increase the awareness of and utilization of' wellness offerings that exist on the campus today. Increase the non-smoking areas in academic buildings, residence halls, food service, and lounges. To develop a centralized wellness resource center where infomational materials on all six dimensions of wellness would be available on a walk-in basis to students. Accredited wellness.major. Q Increase the utilisation of campus tv, Pointer, and journal articles for the promotion of wellness. Expand health related courses within the health and physical education department. A personal or group wellness recess. This would be an officially designated time once or more each semester where people through- out the University in all positions from academic, student, clerical support, maintenance, and so on would be given an official designated time to investigate one of the dimensions of wellness for themselves. Weekly radio spots to promote health seeking behaviors. Faculty support to increase responsible use of alcohol. Twelve The first part 4.6 4.6 6.4 4.5 4.3 4.3 6.3 .4.2 ‘02 4.2 k.1 4.0 4.0 -4.0 17. 18. 19. 20. 21. 22. 23. 26. 26. 27. 28. 29. 30. 31. 32. 34. 35. 190 Incentives to increase the activity levels of the students and faculty on campus. Here wellness workshops for students and faculty. Provide more opportunities for art to be displayed throughout the campus. More fitness facilities are needed. whole bran on the tables. Provide vegetarian entrees that are hot in the grid such as vegie pastries. Alter the 4 credit physical education requirement with more emphasis on health related courses. Faculty improvement programs to increase the faculty's participation in personal wellness activities. To improve resident assistant training in dormitories with particular emphasis on encouraging responsible use of alcohol. Encourage the development of alternatives to the square. Develop a wellness oriented nightclub. Paid student leaders for wellness promotion. Encourage broader bus service and car pooling for students. Dorm representatives for SHAC to insure broad based input. Assertive training in dorms to improve the environment concerning loud, abusive activities and alcohol related confusion. Give support and encouragement for competitive mental sports. Construct more whirlpools, hot tubs, saunas, and a new swimming pool. ' Encourage the sanction for faculty time to pursue personal wellness. Increase health hazard awareness advertisements and programs. Develop a women's health issues course. An automated dial-a-videotape system so students could obtain information in the privacy of their room or designated room in a hall. Broaden the Support by ongoing programs for all levels of staff Within the University - this includes faculty, academic staff and classified. APPENDIX G CORRESPONDENCE TO THE COMPARATIVE INSTITUTION REGARDING RESEARCH PROPOSAL “ ‘ ‘ 119]. "“" L. Joan Hull October 19, I984 I am writing at the recommendations of Fred Leafgren, Assistant Chancellor of Student Life, University of Wisconsin - Stevens Point, and Max R. Raines. Professor and Chair of my doctoral committee, Department of Administration and Curriculum, Michigan State University. \ At present I am embarking on the finalization of my dissertation writing with the spirited determination of defending by the first of the year. The purpose of this study is to investigate the potentiality of the Wellness Movement within institutions of higher education and the Movement's propensity for changing health practices of college students towards a more positive and healthful approach. This study will compare and analyze the attitudes, knowledge and orientations of students from two separate institutions of higher education which are similar in many variables but differ in their approach to Wellness programming. One institution provides Wellness programming, the other no discerning effort in Wellness programming. The University of Wisconsin - Stevens Point, has been identified as the experimental school by virtue of their thoroughly defined and articulated Wellness program. (Please refer to enclosures.) Throughout the past few months of assessing the Mid-West for a comparable school to serve as my control group, has been ‘5 identified to best serve this purpose, and it is at this time I would like to ask for your permission and cooperation to survey your students for the purpose of comparing and analyzing. As you have noticed, I have enclosed pertinent written materials regarding the University of Wisconsin - Stevens Point Wellness program and Chapter III of my dissertation for your review. Please pay special attention to the Life Assessment Questionnaire (LAQ), for it is this instrument that I will be utilizing for my data collection. Reliability coefficients and percent matches are also enclosed for your review. Financial concerns have been eliminated through the gracious offer of Dr. Leafgren in providing me with as many LAQ as needed, and scoring time as well. I would greatly appreciate your consideration of my request, and I will be contacting you in the near future to discuss any questions, concerns or thoughts you may have regarding this research effort. Thank you for your kindness in the matter. Enclosures Sincerely, cc: Fred Leafgren, Ph.D. «4;—S~=7l—rv——-=~él~/“¢———~- Max R. Raines, Ph.D. L. Joan Hull 192 MICHIGAN STATE UNIVERSITY ”lam” mum-Women.“ ppm 0! mm aeronautics museum April 5. 1985 Dear I hope you had a good visit in Chicago and that papers you may have presented at AERA were well received. We have enclosed Chapters I and III of Joannie Hull's dissertation. We were delayed by a most unfortunate incident. The typist completed the drafts just prior to major Surgery Unfortunately in her anxiety and presses of finishing other assignments she lost Joannie' s dissertation in the computer along with the floppy disc. After a period of recuperation she was sufficiently strong to complete another copy frqn the handwritten manuscript. This of course threw the project off schedule and caused the manuscript to go to our Human Subjects Committee just prior to Spring break. The doctoral committee is quite pleased with the design. We are hopeful that the delay will not pose serious problems at I have enclosed a draft of a memo which might be used with any changes you might deem necessary. Ms. Hull is planning to come to during the period of administration to assist any way she can. She will work out details for getting the inventories scored at Stevens Point and returned. We think the inventories should be returned from Stevens Point in sealed envelopes with self-selected code numbers on the envelope to protect anonymity. This way they could be picked up by students at their convenience from a designated location. It is our understanding that scoring, and profiling can be accomplished in a brief period. Normative results for will also be supplied in a short time.' Results of the completed study will be available mid-summer or sooner. I'll be calling Monday afternoon to answer any questions you may have. Sincerely, 71x96 Mex R. Raines Professor PS. Recently I was discussing the project with Dr. ( and I have been friends and colleagues for many years.) He was quite pleased with the project and felt that it was in keeping with long range plans for strengthening health services that were projected during his presidency. MSU is a- We. Andes/had Opportunity [mauled-'e- 193 May 17, 1985 Dear Dr. Per your discussion with Max R. Raines, Department of College and University Administration, Michigan State University, I am assured you are aware of my pursuit of study in regards to my doctoral dissertation...I am attempting to explore the potentiality of the wellness movement within Instituting of Higher Education and the movements propensity for changing health practices of college students towards a more positive and healthful approach. This study will compare and analyze the attitudes, knowledge and orientation of students from two separate institutions of higher education which are similar in many variables, but differ in the approach to wellness programming, one institution provides wellness programming, the other no discerning efffort in wellness programming. Presently, I am seeking approval of Human Subjects Committee and I have been in communication with Dr s and in this regard. I have already obtained the approval or Micnigan State University (please refer to enclosure). In order to expedite the sampling procedure, Dr. . had recommend I contact you in an effort to locate and contact the appropriate faculty and/or other staff needed for this activity. What is needed is: help in identifying classes in which faculty would allow the asseSsment of there student, either throught passing out the instrument (Life Assessment Questionaire) during class time a asking for a response at that time or possibly passing the instrument in class and asking the students to return completed form during the next class seSSLOn. Which ever is the most feasible would of course be left to your discretion. For statistical purposes what is need is a response rate of 50 students equally distributed among the four class levels. The methodology used will hopefully account for equal gender distribution, therefore, the total sample needed is 200. If this could be done at the beginning of your summer session, it would greatly be appreciated. 194 May 17, 1985 If I can provide with further detailed description, please do not hesitate to call, however I will be out of the stare until June 1, therefore I may be reach in Washington, D.C. at Thank you for your kindness and consideration in this matter. Sincerely, .A:.~_'AL—y§r*19é‘1~m L. Joan Hull Enclosure CF: { Max R. Raines Ph.D 195 June 10, 1985 Ms. L. Joan Hull Dear Ms. Hull: I am sorry that l was out of town when your letter of May 17 arrived asking for our cooperation in conducting a survey in some of the summer school classes at My schedule will not enable me to make contact with the faculty members who are teaching summer school to obtain their permission and cooperation in submitting and collecting the surveys in their classes. What I will do, however, is provide you with the classes that will contain sufficient numbers of freshmen, sophomores, juniors and seniors to meet your sample size and the names of the faculty who are teaching those courses along with their addresses. I would suggest that you make direct contact with them to solicit their support. I will write a memorandum to each of them indicating that is cooperating in this research study and that you will be contacting them directly to see if they are willing to assist you in this project. Attached is a list providing the names of courses, faculty members, and their addresses. Sincerely, 196 Ms. L. Joan Hull June 24, 1985 Dear Per our phone conversation of 18 June 85, I would like to thank you for allowing me access to your students in an effort to collect partial data for my doctoral dissertation. It was my understanding, we decided upon giving the students questionnaires at the end of class, asking them to complete it at home and return it the next class period. As I informed you, I will be in the area July 1-5, at this time I will contact you to arrange specifics and discuss with you any logistical concerns, if any. If you have any questions prior to my visit to , I may be reached in at Until then, thank you for your kindness and consideration in this matter. Sincerely, .4:.\_,l.—.__°qu—‘”__—" L- Joan Hull APPENDIX B HUMAN SUBJECT COMMITTEE APPROVAL COMPARATIVE INSTITUTION 19'7 April 24, 1985 Dr. Max R. Raines Department of Educational Administration College of Education Erickson Hall Michigan State University East Lansing, Michigan 48824-1034 Dear Dr. Raines: A doctoral research proposal by L. Joan Hull to assess "wellness" among ' students was brought to my attention by Dr. of He raised with me the issue of human subject review. University policy requires that all research using University students must be submitted to the University's Human Subjects Research Review Committee whether or not the research has been reviewed by a review board external to the University. I have enclosed an application for conducting research on human subjects. It should be completed by Ms. Hull and signed by you as department chair. human subject policies and procedures closely follow 45 CFR 46. Research is either (1) exempt from review (but reported), (2) given an expedited review because of minimal risk to the subjects or (3) subject to full Committee review. The criteria for all three are detailed in 45 CFR 46. I see no real problems with Ms. Hull obtaining approval as long as privacy and anonymity is preserved and subjects can refuse to or withdraw from partici- pation. If you have questions, please contact me at Sincerely, 1.98 MICHIGAN STATE UNIVERSITY a COLLEGE O! DUCATION EAST MNSING ' MICHIGAN ' «Old-lo“ DEPAITMENT OF EDUCATIONAL ADMINISTRATION EIICILSON HALL May 10, 1985 Dear Dr. I have enclosed my application for your review including other related material. F If you or any other member of your staff and/or faculty have further _ questions, I may be reached at however, from May 15 until ’: June 2 I will be in Washington D.C. at Please do not hesitate ' to call. I am sorry for the apparent difficulties with my printing, if you would prefer it typed please send another form and I would gladly make arrangements to have it typed. Sincerely, , . Joan Hull LJH/bh CC MSUiu. Alli—.1... - a .n , . 199 May 16, 1985 TO: FROM: Exempt status has been approved under . 116.101 (3) of 45 CFR 46 for your project 1 "Wellness Programming within University Health Services." Please inform us of any revisions to your approved research plan. JOS:KE CC: APPENDIX I LIFESTYLE ASSESSMENT RESULTS AND INTERPRETATION 200 [LHFESTFYLE ASSESSMENF RESULTS ' amp @@U@: SOCIAL ‘ -3.- SP ‘ns' 1.7—.3 ':r'_1f~esu'-3'mcrovernem u “’1 South Hall 'JWSP - Sievens Pomt. WI 54481 "‘5‘ 346-2511 201 We are pleased that you have elected to participate in the Lifestyle Assessment pro- gram. We hope that the LAQ results will provide information and direction in support of your efforts to live a wellness lifestyle. This evaluation instrument and the analysis it provides were designed to allow you to record information pertaining to your lifestyle. and to show you how you can make pos- itive modifications in your lifestyle. toward wellness and greater longevity. We define wellness as an active process through which the individual becomes aware of and makes choices leading toward a more fulfilling life. We invite you to read this document carefully, to understand your current lifestyle and what it is doing to and for you. to reflect upon what you might wish to do to enhance your lifestyle. and to assess — and exercise — your choices toward a more fulfilling life. PHYSICAL SOCIAL THE SIX DIMENSIONS OF WELLNESS YOUR GUIDE TO THE LIFESTYLE ASSESSMENT QUESTIONNAIRE (LAQ) The results of your Lifestyle Assessment Questionnaire (LAQ) are contained in this Guide. The results and Guide will enable you to assess your lifestyle and may be used to help you examine your lifestyle behavior and current level of wellness. They may also be used to identify the health hazards you face at this point in your life. It is important .to remember that you are your own best health manager. Computerized results will not transform your wellness condition. but they can aid you in examining the day-today decisions which make up your chosen lifest la. The LAQ measures the outcomes of decisions you have already made about your Ii estyle, and provides a base to assist you in your quest for high level wellness. ,7 ,/M 776% -/” I" Bill Hettler. M.D. 9 (ETA-’4. Q‘LY‘ ’.« In recognition of the personal nature of f. manv of the items contained in the L.A.O.. - AW" 202 TRADITIONAL MEDIONE HEALTH PROMOTION flrfiniqd-p‘m-‘fia nuanced-av WMM.D.MPK.IWM m TIM. M.D. Cs-l - ll tussle. M.D.. M- M. m THE WELLNESS CONTINUUM The disease care system in the United States is por- trayed on the left sude of the Wellness Continuum. Most DhySICIanS are trained primarily to address disabilities and Symptoms. and to record premature deaths. The best medical care can only bring yOu back to the midway pornt of the Wellness Continuum -- a pomt of no illness and a state of mediocrity. (Mediocrity as used here means the absence of disease, but not the highest level of health possrble for you.) We emphasrze that traditional medical care performs a very valuable serVIce. Expertise is needed in certain sit- uations. but to m0ve beyond the midpoml and to the right of the Continuum. it IS important that you assume the responsmility for worse”. through careful attention to your Iiiesryle. M0vement toward high level wellness can be achieved through education. growth In personal awareness. altitude clarification. and changes in lifestyle. In the center portion of your GUIde. there are four I4) headings which describe each section of the LAO and :orrespond to the (ESUIIS of the questionnaire you com- oleled: Section I —— WELLNESS INVENTORY Section 2 — PERSONAL GROWTH Secuon 3 — RISK OF DEATH Section 4 — MEDICAL ALERT AS YOU BEGIN, CHECK TO BE SURE THAT THE VITAL INFORMATION AT THE TOP OF YOUR PRINTOUT IS AC- CURATE AGE. RACE. GENDER. HEIGHT. AND WEIGHT\. ANY ERRORS IN THE RECORDING OF THIS INFORMA- TION MAY INVALIDATE THE RESULTS OF YOUR LIFE- STYLE PRINTOUT If you find that any of this Information :5 not acourate. correct it and return y0ur LAQ for re- SCOrIng. ‘ If the information at the top of your printout IS correct. you are ready to begin reviewung the results of mm Life- style Assessment Questionnaire by starting With the first section ;' 'he Gurde — :he Wellness Inventory WELLNESS INVENTORY The Wellness Inventory section of the LAO is designed to help you assess y0ur Current level of wellness. Eleven areas ‘Wthh encompass the Six dimenSIons of wellness are measured. They are listed on the next page. 1 W E L L N E S S I N V E N T O R Y 203 Physical Exereiae: Measures your commitment to maintaining phySical fitness Physical Nutritional: Measures the degree to which you choose foods Men are consistent with the dietary goals of the United States. as published by the Senate Select Committee on Nutrition and Human Needs. Physical Sell-Care: Measures the behavior which helps you prevent or detect early illnesses. Physical- Vehicle Safety: Measures your safe driving practices which mi inimize chances of injury or death in a vehicular acm ident Physical Drug Abuse: Measures the degree to which you are able to function without the unnecessary use of chemicals. Social-Environmental: Measures the degree to which you contribute to the common welfare of the community. This emphasizes your interdependence With others and With nature. Emotional Awareness & Acceptance: Measures both the degree to which you have an awareness and acceptance of your feelings, including the degree to which you feel posuive and enthusiastic about yourself, and life. Emotional Management: Measures the capaCity to appropriately control your feelings and related behaVior. including the realistic assessment of your limitations. Intellectual: Measures the de ree to which you engage your mind in creative. stimulating menta activities. expanding your knowledge and improvmg your skills Occupational: Measures the satisfaction gained from your work and the degree to which you are enriched by that work. Spiritual: Measures your ongomg involvement in seeking meaning and purpose in human existence. It includes an appreciation of the :epth and expanse of life and of the natural forces which exist in the universe. YOUR WELLNESS INVENTORY SCORE Your score is the percentage of points attainable on the wellness statements. The higher your score. the higher y0ur level of wellness Wellness Inventory scores appear on printouts as shown in the foIIOWing sample format: SAMPLE Category Your Score Group Average Total Average thsicaI-Exercise 79 67 58 Intellectual 82 79 80 Social 52 78 66 Emotional- Awareness 88 90 83 Occupational 99 78 70 Spiritual 83 80 69 Composne Score 84 83 74 Note from the sample above that this person scored 79% for the Physmal-Exermse category. The group With which this person com- Dleted the LAO scored an average or 67%. and the total average for everyone who has ever completed the LAQ was 58%. This format is followed through each wellness dimension and allows you to see yOur score in comparison With others. 204 If your LAQ was processed and returned as part of a group (school, business. etc.) then y0u can compare your scores with the averages for LA” ur grou: and with the averages for everyone who has ever taken the Q. lfy ur LAO was done on an individual basis and not as part of a group. ity was processed as part of a random grow and you should com- pare your scores only with the total average scores. You may also Wish to examine your consistency across the wellness categories. For example. in the previous sample. this person received a score of 99% in the Occupational area and a score of 52% in Social. High level functioning in all areas is a goal consistent with a wellness lifestyle. It you are dissatisfied with your wellness scores in any category you may choose to make changes in your lifestyle. You can improve your wellness scores by making active positive choices about your lifestyle. Suggestions to help you accomplish this task may be found in the “Ma ior Hazards To Y0u” and "Medical Alert" sections of your L.A.Q. results. Socul TOPICS FOR PERSONAL GROWTH In the Topics ‘or Personal Growth Section of the Lifestyle Assessment Questionnaire. you ivere asked to select from a list of educational topics those from which yOU desired I) information: 2) group activities. or 3) con fidential personal aSSistance. This section of the Lifestyle Assessment Questionnaire Computer Printout is a referral source for your personal benef t The computer has been programmed to print information on up to Six Topics‘ or Personal Growth. If you selected more than six topics the com Outer NIH prOvide information on those areas that represent the greatest opportunity for enhancmg your lifestyle. It you would like additional infor- ‘nation that this csmcuter has not provided. please write to us. Ear eacn of "‘e V's—ms for which information has been printed. the com- ..la'TE’f 1.33 STOVICE" " ' Media resoc rces ' AgenCies which offer assistance or information. NOTE If /0ur LAO was processed and returned as part of a group. and your organization provided information for local referral that in- formation NIH be provided in your printout. Otherwise only referral reSOurces available nationally will be listed. If local resources are not listed. Ne enc0urage you to seek them out T O i C S F O R P E R S O N A L G R O W T H IH>mU m0 xm—m 205 The Topics for Personal Growth Section will appear on your printout in this form: SAMPLE PERSONAL GROWTH SECTION—AUTOMATED REFERRAL The following resources have been found to be helpful in learning about the topics: STOP SMOKING PROGRAMS A. MEDIA Books—Leaming to Live Without Cigarettes— Allen. Angermann, and Fackler . COMMUNITY RESOURCES YMCA—Stop smoking programs Your Family Physician American Cancer Society Your local hospital American Lung Association (11 From this sample printout. you can see that this person's request for i information on smoking cessation resulted in a list of resources available . for use in dealing with this topic. Similarly. if you requested information. ' group actiVities. or confidential personal assistance on any of the educa- tional topics. your printout will include a referral list for up to six topics that you have choosen. 2-06 RISK OF DEATH The Risk of Death Computer printout details factors which influence your longevity. Longevity is an indirect measure of quality of life. By understanding and taking action on the information provided in this section, you may increase your longevity and thereby the opportunity to reach even higher levels of wellness. The Risk of Death section consists of these subsections: (1) Life Expectancy Re- sults. l2) Major Hazards To You. and (3) A Hazard Summary. The first subsection. Life Expectancy Results. appears on your printout in this format: LIFE EXPECTANCY RESULTS SAMPLE 25 30 35 40 45 50 55 60 1 Average years of remaining life in 'fOurseX.age,racengUp 53....OICOQOCOIODOOQ 2 Your expected years of remaining life based on your answers 38 3 You can achieve this expected years Ofrema'n'ng‘lfe 56eeeeeeeeeeeeeeeeeeeee This sub-section. presented in the form of a bar graph. provides three types of ac- tuarial information: L we 1 indicates the average number of remaining years of life people of your age. 'ace. and gender. can expect to live. The results shown on line 2 are based on your answers concerning your lifestyle. heredity. and medical history. If you choose to makeno changes in your present life- style. this graph predicts your expected years of remaining life. Lee 3 indicates what you may be able to achieve should you choose to make all the 'i‘eSty'e changes suggested. Later in yOur printout. suggestions will be made on how you can take steps toward greater longewty. The word “expected” has been printed in bold face to emphaSize "ie ‘3Ci that all longevity data is determined by predictions based on previous group ’ESUliS. (The computer cannot actually tell you how long you. as an individual. will live or at what age you will die. The computer makes a prediction using actuarial in- formation.) UI /\ . / l<+5l .‘i‘iO XCD—IJ {MI} ‘I i it.) 207 ' MAJOR HAZARDS TO YOU The Major Hazards to You subsection will alert you to the leading causes of death for your age. race. and sex group It will also show you a comparison of your pro ability of a particular cause of death in comparison to others of your age. race and sex group (labeled "average" on your printout). and explore with you what you can achieve through a positive lifestyle change. The major hazards to y0u are rank ordered on the basis of your responses. The most likely cause of death for you. based on your responses is rank ordered ill. The second most likely cause of death for yOu is rank ordered #2 and so on. SAMPLE MAJOR HAZARD TO YOU Rank Hazard 10 Year Deaths Associated Risk Per . Factors 1 Motor Vehicle Accidents Average 815 Drinking Habits Our 4238 Seat Belt Habits Achievable 489 Riding With Someone Who Has Been Drinking 2 Suicide Average 102 our 518 Achievable 102 i 3 Pneumonia ‘ ‘ Average 14 Smoking Habits a Your 31 Drinking Habits Achievable 6 From the sample above. you can interpret that motor vehicle accidents is the greatest :Cte“7i hazard to this person. Using actuarial tables. a predicted 815 people out of every 100.000 .‘l‘ ' : e during the next ten years from his or her age. race. and sex group because of motor vehicle :2: . dents. This person' s predicted chance is significantly higher at 4238; yet. if he or she Chang: _ 1 the associated risk factors Drinking Habits Seat Belt Habits. and Riding With Someone .iro ~53 Been Drinking an achievable score of 489 could be attained. Occasionally. the achievable chances of death are higher than the average chances 3‘ ; This can occur if you have a family history or personal history which places you at greater r 5x than the average person even when good health practices are followed You can now examine the top health hazards for you and compare your predicted chances sit those of your age. race. and sex gr0up; and determine the estimated increase in longeVity icu : =n achieve by making a positive change in your lifestyle. m HAZARD SUMMARY The final part of this RISK OF DEATH section on your computer printOut is the Hazard Summer Based upon the data you provided concerning y0ur lifestyle. the computer will give y0u a heai * age "and an achievable health age. " This section of y0ur printout will appear in this form SAMPLE HAZARD SUMMARY Based on the Lifestyle Assessment Questionnaire you have completed you have a '-" health age of 33 years If you follow all the suggestions we have given. you can reau .9 mm "eaith age to 15. As yOU can note on the sample above. this person has a health age of 33 years. This means that they have the same risk of death as an average 33 year old person. The com puter also indicates that if this person would follow the suggestions for decreasmg ms or her health age. it c0uld be decreased to the level of an average 15 year old person. You can also reduce your health age by following the suggestions made to you on i. av computer printout. 208 MEDICAL ALERT The Medical Alert Section of the Lifestyle Assessment Questionnaire provides you With ir‘or- mation which you can use to develop your own medical history and health status chart. This sec- tion addresses the following areas: ' Current Problem List ' Current Medications ' Suggested Lifestyle Improvement Needs ' Allergies ' Immunizations ' Resolved Problem List This section will appear on your printout in this form: SAMPLE MEDICAL ALERT SECTION CURRENT PROBLEM LIST Family history of heart disease No recent TB test RESOLVED PROBLEM LIST Lonliness IMMUNIZATIONS CURRENT MEDICATIONS Initial series of DPT Tetanus Booster Within 5 years Has had polio vaccine Rubella status unknown SUGGESTED LIFESTYLE Allergies IMPROVEMENT NEEDS Molds Sober Drivers Are Safer Weeds Stopping Drinking Always Wear Seatbelts Lowering Systolic Blood Pressure L0wering Diastolic Blood Pressure Lowering Cholesterol Level We encourage you to keep a home health record. This section of your computer printout ia" serve that purpose. Things I WITH Can Do OTHERS 0 O 252 2 For Mysell '/.t:s'—3il\isain ’ 5..., Him)...” -,_, “a. I. .- --I ”" Erratic" a": .‘ .‘ r a smut ‘ "1i The most Significant determinate to your quality of life has been shown to be lifestyle choices ias shown in the illuStration ab0ve). ‘Ne hope the Lifestyle Assessment Questionnaire and your computer print0ut have provided .2. ~Ith the knowledge necessary for improvmg the understanding of yourself and the role you :31 piay in aSSuming responSibility for maintaining a high quality lifestyle. 7 l Hmmr> r>O—Dm§ CR —e 209 BEHAVIOR CHANGE CHECKLIST Identify a specific behavior that you would like to change and feel you can change. Start with a less difficult behavior. Make a tally sheet for one week and record the behavior you would like to change. Record the number of times it occurs the circumstances when it occurs your feelings and how impor- tant was the behavior (1 most important — 5 least important). Immediately reward yourself in a healthy way for following the desired behavior. Break the automatic habit Many behaviors occur without conscious thought (smoking Cali! drivmg a car without a seatbelt). Break up the routine. Put your cigarette in a different; ac agree to eat with your opposite hand. etc. a -3 Withdraw rewards. when possmle. for undeSIrable behavior. Change your enwronment if possmle. Look for people and social systems that are compatib e and supportive of your desired behavio FOCUS on the posnive effects rather than what you are losing as a result of the change. Think flexibly. Most limitations are internal. We tend to blame others for our inability to change when creative thinking would prowde an effective strategy for the desired behavior Learn through obserVIng others — healthy others. especially those with whom you can easnv identify Convert difficult goals and complex behavior change into a small and achievable steps ii e.. running a marathon may involve beginning with a short walk/run exerCIse program graduaily evolvmg over a six month or year period into a full marathon.) Practice. practice. practice! Repitition is an important key to learning. When in doubt. consult With knowledgeable others. Learn ”cm /0ur failures. BehaVIor change often times takes time. Thomas Edison .vas :nc- asked vm he oer5isted in his desire to invent a new type of battery in the face of ire 1:?"- failure 49 replied. What failure? I have no failures. Now I know 50000 ways it won t work ' You are rIot a failure when you fail. l 'i I I I \ APPENDIX J HUMAN SUBJECTS COMMITTEE APPROVAL MICHIGAN STATE UNIVERSITY 21.0 MICHIGAN STATE UNIVERSITY COLLEGE OF EDUCATION EAST LANSING ' MICHIGAN 0 “2‘40“ DEPARTMENT OF EDUCATIONAL ADMINISTRATION EllCBON HALL “are“ 19' 1985 MICHIGAN STATE “— UNIVERSITY Henry Bredeck MAR 19 I93) Asst. Vice President 0mg: a; “swan gamma, Res. & Grad. Stds. VP .. 238 Administration Bldg. Dear Henry: This project is designed to canpare responses to a wellness inventory among samples of students from two universities---one having a well developed program and the other exploring the possibility of developing such a program. The experimental university has had a wellness program for almost a decade and routinely administors the instrument to all of its incoming freshmen, providing individual consultations for those who seek interpretations. This university has been “planning to re-administor" the inventory to students to assess "gains" in wellness practices. They have said that Ms. Hull's proposed study gives them the impetus to carry out their plans and they are providing the instruments and computer scoring at no cost to Ms. Hull. It also provides an opportunity for them to compare their scores with the scores of students (in a matched residential setting) who are residing in the control university which is also interested in a "wellness assessment". The students of the latter institution will use code numbers enabling each participating student to obtain the results of the inventory without revealing his/her identity and then if they choose seeking interpretations from the physicians in the local health center. while students in both institu- tions will be invited to participate by administrators of their respective colleges their participation will be voluntary. Group administration of the instrument will be used. Dr. Larry Lezotte is on Ms. Hull's doctoral cunnittee and feels that the proposed methodology adquately protects student rights in what we believe is a useful study. An early appraisal by your committee will be much appreciated since several unanticipated mishaps (like losing the first three chapters in the computer) have delayed Ms. Hull's progress. Sincerely, Max R. Raines Professor of Higher Education MRR/bh HUI-an‘”: .~ . . a .A . , . s. , 211 MICHIGAN STATE UNIVERSITY UNIVERSITY COMMITTEE ON IBEAICH INVOLVING EAST LANSING ' MICHIGAN ' “0 HUMAN SUBJECTS (UCIIHS’ 13! ADMINISTRATION BUILDING HIT) ”,4!“ April 2, 1985 Ms. L. Joannie Hull Educational Administration Dear Ms. Hull: Subject: Proposal Entitledz "A Comparison of Wellness Programs" UCRIES review of the above referenced project has now been completed. I am pleased to advise that the rights and welfare of the human subjects appear to be adequately protected and the Committee, therefore. approved this project at its meeting on April 1, 1985. You are reminded that UCRIHS approval is valid for one calendar year. (If you plan to continue this project beyond one year, please make provisions for obtaining appropriate UCRIHS approval prior to April 1, 1986. Any changes in procedures involving human subjects must be reviewed by the UCRIHS prior to initiation of the change. UCRIHS must also be notified promptly of any problems (unexpected side effects, complaints. etc.) involving human subjects during the course of the work. Thank you for bringing this project to our attention. If we can be of any future help, please do not hesitate to let us know. Sincerely, ‘Henry E. Bredeck Chairman. UCRIHS HEB/jms cc: ’Dr. Max Raines Iltllh-All— ...--n v :— .. . ._. APPENDIX K MISCELLANEOUS CORRESPONDENCE 21J2 _ IIII u w ’P university of wiseonain/otovono point 0 “ovens point, Wisconsin 54401 IIII You have been selected to participate in a research project designed to help us measure the impact of programing here at UNSP. If you agree to help us, we will ask that you complete a new Lifestyle Assessment Questionaire (LAQ) and allow a researcher to use the results of that LAQ and the LAQ you took when you first enrolled at UNSP. ' To repay you for your assistance, we will interpret the results of your latest LAQ, along with those of your first, at no cost to you!!! (We will contact you later about times and places of interpretations.) We believe that the information gained from this project will help us to develop better and more useful programming, and we hope that you will agree to help us. If you wish to participate in the project, please * sign the waiver sheet below; * complete the enclosed LAQ answer sheet; * return both the waiver and answer sheets within 5 days. He appreciate your assistance and feel sure that it will be a valuable contribution to our programming effort. I hereby authorize the University of Wisconsin- Stevens Point to disclose answers from two (2) Lifestyle Assessment Questionaires (LAQs) completed by me; with the understanding that no personally identifiable information will be revealed. This waiver expires upon completion of the re- search project for which it is given, except that the researcher may use the findings in a publication, if appropriate. Signature Date A8013“!!! Chancellor I0! Student Uh 0 (715) 348-4 194 Administrative Ofico 0 (715) 346-2611 213 IEIIDr ’ P university of wieconein/etevene point 0 etevene point, wieconein 54401 Dear student, Thank you for helping us with our research project. Your cooperation and patience, as well as the time you devoted to the project , were greatly appreciated. Although the project has not been completed (it will take more time to interpret all of the data), early indications suggest that our ongoing programming has had a positive effect on the lifestyles of UWSP students. That's great news for all of us! In return for your help on this project, we agreed to interpret the results of your LAQs for you. We have now made arrangements to do that and are enclosing with this letter copies of both your initial and most recent LAQs. (The photocopied LAQ is the first one you took.) If you wish to have your LAQ results interpreted, please come to the Turner Room in the University Center at one of the following times: Monday September 9 4:00 p.m. - Tuesday September 17 4:00 p.m. Once again, thank you for your assistance. cellor for Student Life APPENDIX L MISCELLANEOUS TABLES 214 mHNam. h.m mH HHH ommvm. N.v om HHH Novmh. m.m mm HH hommm. m.m mm HH ommvm. .m.m ma H :meos omega. m.m lbw H NHmhh. v.m mH HHH vacam. h.m m HHH mmHmo. h.m MH HH mwhmm. m.m 5H HH ONNVH.H o.m N H cw: mmmmh. ¢.m 5H H coauMH>oQ coo: lm om< xom coHumw>oo coo: lm omc oomocmum oumocmum :onoauusz .m magmaom> manomnsm Hmmmm. H.m mH HHH hHomm. m.m om HHH hwmmh. N.m Hm HH mmvvm. m.m mm HH MHmmh. H.m NH H c0503 oomhm. mmm hm H mHmNm. H.m mH HHH Hmmom. m.m m HHH mmoom. v.m MH HH mmomm. h.m 5H HH ovumo.H h.m N H :02 VHmmm. o.m NH H :oHumH>ma coo: Im om< xmm . cowumw>oa now: Im om< commemom oumocmum coHusuHumcH o>aumummeou :HmcoomHz Ho Huwmuo>flca ucHom mco>oum omHouoxm ~H oHnmwum> onomnsm :oHusuHumcH an Hoosoo an om< memo: Ho oHnma Humeesm H.H mHnma :0503 CG: xom C0503 Gm: xom 215 vamm. ¢.¢ mH HHH wvva. N.¢ ON HHH ommmv. H.v NN HH mmmNm. m.v mm HH mwomm. N.v NH H :0503 Hommm. m.v lbw H £0603 mmwNe. H.v mH HHH mHmHm. H.v m HHH mmNmm. m.m MH HH MOHmv. m.v NH HH HmHmm. m.m N H :02 ommow. H.v NH H cw: :oHumH>oo coo: lm omm xom :oHHMH>oQ coo: lm om< xom ouoocmum ounccmam mummmm mfiofirm> .v maanum> mamomnsm mwNmm. m.m mH HHH mmomm. H.v ON HHH Nmmwm. N.m NN HH oome. m.m mm HH MOHOQ. m.m NH H c0503 mvao. m.m lbw H C0503 mHomm. H.m mH HHH OHNmm. ¢.m m HHH mvmwv. m.m MH HH vmvwv. N.m NH HH NNvmm. m.m N H cw: NmmoN. N.m NH H :02 COHuMH>oo coo: Im om< xom :oHuMH>wn now: Im .om< xmm eumccmum oomocmum ucHom moo>oum :oHuouHumcH o>Humummeoo . chcoomHB Ho Hunno>Hca oumu HHom um oHQMHHm> onomnom coHusuHumcH Ho Hoodoo an omr memo: Ho oHnma mumeeom .©.ucou H.H mHnma 216 Hovwm. m.m mH HHH mvav. w.v ON HHH mmmov. m.m NN HH OHmHv. m.v mm HH NNmVN. m.m NH H :mEOB mmwom. N.¢ NN H OMNON. m.m mH HHH MNwmv. N.v a HHH mHowm. o.v MH HH VNNNv. N.v oH HH HlmmHmm. m.v N H cw: Nwon. m.m NH H :oHuMH>oo coo: lm om< xom :oHumH>mQ com: lm om< oumocmum oumocmum HmucwamouH>cm cw oHQMHHm> onomnsm Hvav. m.v mH HHH mommH. m.v mm HHH meNm. w.¢ NN HH NNomv. m.v mN HH NmmmN. m.v NH H cmEOZ NmNmm. m.v NN H NNwmm. m.v mH HHH Hmwev. m.v m HHH mmmmm. N.v NH HH HwMHN. m.v NH HH mHmmH. N.v N H cw: mwNov. m.¢ NH H coHumH>wQ coo: Tm om< xom :oHuMH>oQ com: Im out eumecmum enmecmom :oHusuHumcH o>Humummeoo usHom mco>wum :HmcoomHB Ho muHmno>HCD ow: moan .mlwwmmmmm> mHmownsm :oHusuHumcH an neocow HQ om< mcooz mo oHnme Humsesm .o.u:oo H.H mHQmB :0503 xom CQEOZ so: xom 217 mmwvm. H.v mH HHH omwwv. v.v 0N HHH mHmHm. H.v NN HH OHmmfi. N.v mm HH manm. ~.¢ .NH H :oeoz mlom. ~.a mm H vaHv. H.v mH HHH wmvwm. m.m m HHH Nmomm. N.v MH HH mmwmc. N.¢ mH HH ooooo.o v.v N H :02 mmva. H.v NH H COHHMH>oQ now: Im mum xom :OHumH>oQ coo: .lm om< oumosmum photomum Homeommcmz HmcoHuoem Hm oHanHm> oHoomnom omva. m.v mH HHH mmNmm. m.w mH HHH Mvam. H.¢ NN HH vaNv. m.¢ mm HH mammm. m.v NH H :0803 memmv. m.v NN H mvav. m.¢ NH HHH Nvmmv. . o.¢ m HHH vavm. m.v mH HH MNNvo. v.v wH HH mmNHH. N.v N H :02 NovNN. v.¢ NH H :oHuoH>oa coo: lm 7 mac xom coHHMH>mn now: Im om< onmocoum pumpamum uCHom wcm>mum :oHusuHumcH o>HumummEoo mmmcoumzc HocoHuoem HN oHQMHHm> mHmomasm COHHSHHumcH an Hoocoo HQ om< memo: Ho oHnma Humeeow .o.u:ou H.H wHQMB :HmcoomHB Ho HuHmHo>HCD C0503 C02 xom :0803 cm: xom 218 Vvam. H.v OH HHH OMva. v.v mH HHH HNONv. O.¢ ON HH NOOOm. v.¢ Om HH seems. o.q 5H H cmeoz mmmmmu m.v an H mHOMO. O.¢ OH HHH mOVNN. O.v m HHH mHmmo. m.m NH HH HOmme. m.v OH HH OOOOH. m.¢ N H :02 HmNNO. O.v OH H :oHuoH>oQ coo: Im oma xom :OHHMH>oQ com: lm om< eHmocmum oumoamum HmcoHummwooo ~OH oHQMHHm> onomnsm HHmmO. N.m OH .HHH OHmvm. m.m ON HHH MNOHN. m.m NN HH NONmm. m.m Om HH vOmmO. m.m NH H c0503 NOMHN. m.m NN H mONOO. m.m OH HHH vaMO. N.m a HHH HNmOO. N.m MH HH OOmvm. O.m OH HH OOOO0.0 O.m N H :02 HmmOO. m.m NH H coHuoH>oo coo: lm om¢ xom coHuoH>oQ now: Im om< ouoocmum ouoocmum COHHDUHHmC H w>HHMHMQEOU ucHom mco>oum chnoomHz Ho NuHmHo>Hc= HosuooHHoucH Ha mHanHo> onomnsm coHusuHumcH an Hopcow HQ ems memo: Ho oHnme Huoeesm hPuaoo H.H mHan :0503 so: xmm Ems—03 so: xom 219 no can whom» mN u HHH moHo Hams «muom a HH moHo How» mHIOH u H was "Hox NmNmO. m.m OH HHH OMOOO. v.v OH HHH vNOmN. O.m HN HH VHOOO. H.v Om HH NNHON. O.¢ NH H c0503 ONOMN. H.v NN H c0503 OONOO. O.m OH HHH HOOmN. N.m O HHH HMNON. O.m MH HH HvOOO. O.m OH HH HHNON. v.v N H C02 OONVO. O.m NH H 60: :OHuoH>oo coo: Im mum mum coHHMH>oQ com: lm mad mum oumecmom oumocmom ucHom mco>oum :oHosuHumcH o>Humummeou chcoomH3 Ho HuHmHo>HGO HasuHqum .HH mHnaHHm> mHmomnsm :oHuouHumcH HQ Hoocow Na omw memo: Ho oHnma mumesom .O.»COU H.H anme 4 NmNev. ~.v Nm NHNmm. o.¢ mm mNNNv. H.v ON o>Humummeoo mNNNm. v.v Om Ommom. m.v NM NmNmO. m.v mm mmISO :oHumH>oo com: 2 20HuoH>oa com: 2 :oHHMH>oo one: 2 oumocoum ouoocoum oumosmum Hummmm oHOHno> we oHQMHHm> onomnom OOONO. m.m Nm OmmHm. N.m mm NOONm. m.m ON o>HumHmmEoo «ONmO. O.m Om NOHOv. O.m Pm vamO. N.m mm mmISO :oHuoH>oo com: 2 COHHMH>00 com: 2 :oHHMH>oo cow: 2 oumocoum cumocmum pumocmum oumo HHom .m oHanHo> onomnsm HmHmo. m.m Hm momma. >.m mm mmaHm. m.m cm o>HumHmmeoo HmmHN. m.m om «OOOm. O.m NM HONON. O.m mm mmI3O 0 coHuoH>on com: 2 :oHHMH>oO com: 2 coHHMH>on com: 2 . n onmocmum oumoemom oumocmum :oHoHuusz .m mHanHm> mHmomnam ommmN. H.m Nm vaOO. m.m em momON. N.m om o>Humummeoo OaOOO. N.m om lleMbNhl O.m NM mOmHO. m.m mm mmlzo coHuoH>oo com: 2 coHHMH>oO com: 2 :oHHMH>oo com: 2 ouoocmum oumocmum oumpcmum omHoHoxm HH mHQMHHm> onomnsm HHH mmm HH mm< H owe :oHosoHHmcH No mam more: Ho oHnoe mumeeom N.H mHnme 221 mmomm. H.o om mmomo. H.o mm mmomm. ~.o om m>HumHmoeoo oonm. ~.o om «memo. ~.o mm oommm. H.o mm amigo :oHHMH>oO com: 2 coHuoH>oO com: 2 :OHHMH>mQ com: 2 UHMUGmuw Ouwflcmum cunncmam ucwfiwmmcmz HMCOHUOEM .O wHQMHHm> mHmomflfim oommo. m.v om oommo. m.o mm oomoo. o.o om m>HumHadeoo oommo. m.o mm omHmo. m.v mm momoo. o.o mm amigo Gowumfi>00 Saw: 2 COHHMH>00 saw: 2 COHUMH>¢Q 2mm: 2 QHMUCQHW Gunfizmum UHMUGmum mmwcmhm3< HmGOHuOEW .N wHQMHHm> meOmQDm Hommo. m.m mm momma. o.m mm mommo. m.~ om m>HumHmoeoo Hooom. o.o om momma. ~.o om HHoom. H.o mm amigo coHHMH>oO .cmoz z :oHumH>oQ ,cooz z coHuoH>oO com: 2 oumoomum oumocmum concomom ucmscouw>cm HO GHQMHHM> meomDDm oooHo. m.o om mmooo. o.o mm ommom.. o.o om m>HumHmdeoo oomom. o.o om mHooo. o.o mm onom. o.o mm amigo :oHuoH>oO com: 2 coHHMH>oO coo: z coHumH>mQ com: 2 oumocmom oumocaum oumoomum om: mono Hm oHanum> onomnom HHH moo HH mam H mm< :oHusuHumcH an 0mm memo: Ho oHnoa Nmmsesm .o.uooo ~.H mHnma m: can mumoh vN moHo Hams omuom moHo Hams mHImH HHH mom HH moo H mom ”mom oommm. m.m mm ommoo. m.m om «memo. H.o om m>HumHmdeoo mmmHm. o.o mm mommm. m.m mm ommmo. o.o mm mmuzo :oHumH>mo com: 2 GOHHMH>oQ com: 2 :oHHMH>oO com: 2 @Hmvcmum pumvcmum UHMUGmum ‘ HaoHHHHmmP.HH mHanum> mHmomnom mHmmm. H.o mm omomo. o.o mm ommmo. o.o om m>HomHmoeoo m mmmmm. H.« mm ommmm. m.o mm omooo. m.m mm Hmnzo 2 COHHMH>00 cam: Z COHHMH>MQ HHme 2 COHHMH>OQ Emmi Z oumoomum ouncemum oumocmum HmcoHuommUOOIHOH oHanHm> oHoomnom HHmom. m.m mm ommmm. m.m mm ommmm. m.m om o>HumHmdeoo mmHmm. m.m om mmomm. o.o mm ommmm. m.m mm mmnzo GOHUMHHVGD cmmz Z EOHHMHHVOQ Sam! 2 COHUQH>®D QMOZ Z oumoomum onoomum oumoomum HmouooHHoucH mm oHQoHHm> meomnsm HHH moo HH 0mm mm< :oHusuHumcH mo mm< mono: Ho oHnme Humeeom .O.u:OU N.H mHnme 223 mmva. m.m NO coeoz NmONv. m.v OO coeoz HomecouH>cm mmOOO. o.v ow no: OmMNm. H.v NH so: O :oHHmH>mo new: 2 :oHumH>oO com: 2 oHnoHHm> oumocmum oumpcmum onomnom OHMOO. m.v NO coeoz NHHmv. O.¢ OO :0203 mm: mama NNNON. ¢.e oh no: mwNOm. O.v NM co: m cOHHmH>oQ com: 2 :oHuoH>oo com: 2 oHQMHHo> oumocoum oumccmum onomnom Hummmm mHmmv. ~.v NO coeoz mHmOm. v.v OO :oeo3 oHoHno> NNOHO. o.¢ mm co: mvam. N.v mm :0: w :oHHMH>oQ cow: 2 :OHHMH>oQ com: 2 oHQMHHm> oumocmum unaccoum oHoomnam NMOvm. O.m NO :oeoz OOmmm. m.m OO soeo3 ouou HHom womHO. m.m 9w so: mHmNO. O.m mm co: m :OHUMH>oo com: 2 :oHHMH>oQ com: 2 oHQMHum> pumosmum oumocmum onomnsm OHmON. O.m NO :oeo3 mOOVO. m.m OO coeoz COHuHuusz NOmHN. m.m Ow so: ONOMO. m.m mm no: N COHumH>oO com: 2 :oHuoH>oo com: 2 oHQMHHm> oumocmum ouoccmum onomnsm «HomO. H.m OO c0503 mNOVO. O.m OO :0503 omHoHoxm OmOmO. m.m oh so: OOOMO. O.m mm cm: H COHuoH>oO com: 2 :oHumH>oo com: 2 oHQMHHm> oumocmum. 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Hoocoo m0.000H mOOOm.memOmN H MOOOm.memomN coo: umoe umHHm .m mommmmm eooooum mmmmmmw ooucom Ho Ho Ho coo: mooumoo 55m HoomooHHoucH .m oHcoHHo> <>oz< ousmoo: cocoomom Hosuoco .U.HCOU O.H oHQoB onomnom mooocmmmo 247 mo. no ucooHHHcmHm I mm mm mm assoc ommHm.mN oeeee.mo mNmNm.mm HmoHoHoz oooom.om Nmmmo.em mmmmm.mm ammo oeooom momem.mm ommmm.mm Hmomo.mN some mmHHm ooooo.mI ooooo.HI u Hmocoo HooHonz oHoeom oHo: oHcoHHo> oHoomccm ucoocomoo ccooom now mcoo: HHoU NOOeO.HeN em OOOmN.OOONN Honum mNNm.o mm.o NeHmm.OmN H NeHmm.OmN Hoocoo oco ousmoo: oouoomom Omoo.o oo.m eHmOm.mOHN H eHmOm.mOHN oHomoo: oouoomom Home Ocooow mmmmm.Nom em HeHeH.OeNNe Houmm OONo.o mm.m HNOOO.NHON H HNOOO.NHON Hoccoo OOO0.0 mm.OONH Ommmm.ONeOOm H Ommmm.ONeOOm coo: woos umHHm HHHHHcocoum .m mom eooooum mmmmmmw oousom HHoe Ho Ho Ho coo: mooumoo sow HocoHHocoooo .oH oHnoHHo> oHoomnom Hcoocomoc m>oz< ousmooz oouoocom Hoznogo .U.ucou OIH oHnoB APPENDIX H COPYRIGHT PERMISSION 248 I P university of wieconsin/stevene point 0 stevene point, Wisconsin 54431 IEIIDr Permission is granted to L. Joni Hull to reprint the entire Lifestyle Assessment Questionnaire (or excerpts from) and Lifestyle Assessment Questionnaire interpre— tation documents for her doctoral dissertation at Michigan State University. This permission does not extend beyond the stated use, and specifically excludes publication rights beyond any reproduction required by Michigan State University for the granting of the doc— toral degree. / 16.55 Cruz @01 M. Bill Hettler Co-Director National Wellness Institute 249 I P university at wieconein/etevene point 0 etevene point, wieeonein 54431 IEIIF Permission is granted to L. Joni Hull to reprint the entire Lifestyle Assessment Questionnaire (or excerpts from) and Lifestyle Assessment Questionnaire interpre- tation documents for her doctoral dissertation at Michigan State University. This permission does not extend beyond the stated use, and specifically excludes publication rights beyond any reproduction required by Michigan State University for the granting of the doc- /3_ Sick/t '5 Dennis Elsenrath Co-Director National Wellness Institute toral degree. 250 IEIIF I P university at wieconein/etevene point 0 stevene point, wieconein 54441 Permission is granted to L. Joni Hull to reprint the entire Lifestyle Assessment Questionnaire (or excerpts from) and Lifestyle Assessment Questionnaire interpre- tation documents for her doctoral dissertation at Michigan State University. This permission does not extend beyond the stated use, and specifically excludes publication rights beyond any reproduction required by Michigan State University for the granting of the doc- toral degree. Co—Director National w l ess Institute Auietent Chancellor for Student Life 0 (715) 346-4194 Adminietntive onto. 0 (715) 846-2811 BIBLIOGRAPHY "'86 Cost of Heart Disease Estimated.an: $78.6 Billion," The Detroit Free Press. January 13, 1986. Abse, Dannie. Medicine on Trial. New York: Crown Publishers, Inc., 1967. Adams, Ruth. "Vitamin C vs. Cancer Research: Linus Paulings Defense," Better Nutrition, the Consumers Guide to a Better Life, Healthier Life. May 1985, 14-16. Aday, LuAnn, Ronald Anderson, and Gretchen V. Fleming. Healthgare in the U.S., Equitable for Whom? Beverly Hills, London: Sage Publications, 1980. Allison, John. "Respiratory Changes During Transcendental Meditation," Lancet. 1970, vol. I, 833-834. Amkraut, Alfred and George F. Solomon. "From the Symbolic Stimulus to the Pathophysiologic Response: Immune mechanisms," International Journal of Psychiatry in Medicine. 1975, vol. 5, 541-563. .Anand, B. K., G. S. Chhina, and B. Singh. 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