HEALTH PROMOTION SFU Health Promotion Rationale for Embedding Conditions for Well-being in Academic Settings Prepared by Alisa Stanton, MPH Rosie Dhaliwal, MEd, RD Tara Black, MSc Crystal Hutchinson, MEd, CHES July, 2015 Copyright © 2015 Simon Fraser University Copyright © 2014 Simon Fraser University Well-being in Academic Settings www.sfu.ca/healthycampuscommunity/academic-settings HEALTH PROMOTION Introduction Academic departments and faculties strongly influence students’ experiences at university and provide a core setting for enhancing student well-being. Well-being is created through the experiences of our everyday lives, and is influenced by diverse stakeholders, many of whom are outside the traditional health realm (WHO, 2014). Faculty units often have their own unique cultures and norms, which influence student experience, sense of community and overall well-being. In addition, academic units are often the primary point of interaction between students and the institution, and the communications, experiences, programs and policies that students encounter within the academic unit can greatly shape their overall experience on campus and their personal and collective wellbeing. The academic unit is therefore a central setting within which conditions for well-being can be created and enhanced. Despite the potential for academic units to take an intentional role in enhancing conditions for wellbeing, there is limited documentation on how academic settings can be structured to support well-being. Using literature from workplaces, schools and higher education settings as a foundation, the Well-being in Academic Settings projects aims to explore these issues by outlining some of the primary ways through which academic units can positively impact well-being in higher education. This work is one component of SFU’s Healthy Campus Community initiative and builds upon the Well-being in Learning Environments project which focuses on the classroom as an important setting for creating conditions for well-being. There is increasing evidence from workplace, school and higher education settings about the value of purposefully creating environments that enhance well-being. Benefits include enhanced productivity, learning, satisfaction, engagement and retention (Caulfield, 2007; Harter, Schmidt & Keyes, 2002; Rowe, Stewart & Patterson, 2007). As such, taking action to create a Healthy Campus Community is not only beneficial for students, but also contributes to the core business of higher education. This work is innovative within Canada, and an overview of current projects can be viewed at www.sfu.ca/healthycampuscommunity.html Conditions for Well-being in Academic Settings The following conditions for well-being in academic settings have been identified through a process of literature review as well as consultation with campus stakeholders and students at SFU. The conditions are complimentary and overlapping to one another and together they provide a framework that can help guide action toward enhancing positive well-being within academic settings. Social Connection Social connection is about providing a sense of community on campus that helps students feel welcomed and connected within the campus community. Supportive Institutional Culture A supportive institutional culture embodies values of well-being, respect, fairness, kindness, transparency and flexibility and ensures students feel welcomed within the institution. Reducing Undue Stress Reducing undue stress means providing students with a level of challenge that enhances and supports optimal learning while minimizing unnecessary stress. 1 Well-being in Academic Settings www.sfu.ca/healthycampuscommunity/academic-settings HEALTH PROMOTION Opportunities for Personal Development Personal development is about enabling students to develop as whole people and engaged citizens who will succeed both at university and beyond. Strengthening Balance and Resilience Strengthening balance and resilience is about providing students with the tools, resources and opportunities to maintain optimal health and well-being. Inclusivity Inclusivity is about ensuring equity, safety and a sense of inclusion for all members of our campus community. Involvement and Engagement Involvement and engagement is about ensuring the meaningful participation and contribution of all community members and students. The following sections describe the above conditions for well-being in academic settings in more detail, providing background information on how and why these conditions are important to consider within a higher education context. Social Connection Social connection has been widely shown to have a beneficial effect on overall experiences of stress and coping (WHO, 2005), and correlates with both individual resilience and community cohesion (Cooke, Friedli, Coggins, Edmonds, Michaelson, O’Hara, Snowden, Stansfield, Steuer, Scott-Samuel, 2011). Similarly, social relatedness is one of three basic psychological needs associated with improved well-being and motivation through the theory of self-determination which is based on over 20 years of research evidence (Ryan & Deci, 2000). Within school and higher education settings, a sense of connection has been associated with various positive outcomes related to learning and well-being. Strong social connections with both peers and instructors has been associated with improved academic outcomes, retention, decreased high-risk health behavior and improved mental health and well-being (Bond, Butler, Thomas, Carlin, Glover, Bowes & Patton, 2007; Hoffman, Richmond, Morrow & Salamone, 2002). Social connectedness and sense of belonging act as mediators to stressful situations, and enhance student resilience and overall well-being. Astin (1993) found that although there is an overall decline in student emotional health after entering college, students who frequently interacted with fellow students or faculty showed the smallest declines. In addition, students’ self-ratings of emotional health were positively associated with “working on a group project for a class” (Astin, 1993). In a longitudinal study, DeBerard, Spielmans and Julka (2004) found that social support was a significant independent predictor of academic achievement among higher education students. In contrast, lack of social support has been associated with a six fold higher prevalence of depressive symptoms (Hefner & Eisenberg, 2009). School and social connectedness help foster a sense of community that welcomes students to feel engaged and connected in their learning process (California Education Supports Project, n.d; Morrison & Kirby, 2010; Osterman, 2000). 2 Well-being in Academic Settings www.sfu.ca/healthycampuscommunity/academic-settings HEALTH PROMOTION Supportive Institutional Culture The role of institutional culture in enhancing health and well-being outcomes has been explored within diverse settings including schools and workplaces (Rowe et al., 2007; Samra, Gilbert, Shain & Bilsker, 2012). Workplace studies have shown that it is not only important to have strong social bonds with work colleagues, but a sense of care and trust with supervisors and within the organization overall contribute positively to employee well-being (Harter, Schmidt, & Keyes, 2002; Samra et al., 2012). The components of workplace culture that contribute to employee well-being are diverse and include norms such as trust, autonomy, flexibility, respect, fairness, inclusivity, collaboration, sense of belonging, transparent & clear communication, involvement and influence, and support for work-life balance. Combined, these various components of workplace culture can impact on employee well-being, by mediating stress, enhancing overall positive experiences and ensuring job satisfaction. Educational institutions can be considered as students’ workplace, and thus understandings of ways to create supportive workplace environments can also be applied to students (Cotton, Dollard and De Jong, 2002). Within higher education, there has been increasing interest in understanding how the psychosocial environment within the institution contributes to student well-being (Fink, 2014; Oades, Robinson, Green & Spence, 2011; Stanton, Chernenko, Dhaliwal, Gilbert, Golder, Jones & Mroz, 2013), and there is recognition that an ethic of care within the institutions that attends to students as whole people, including their individual and collective well-being, is essential for increasing students’ readiness to learn, and therefore their success (Keeling, 2014). There is also a long tradition of student development literature that acknowledges the role of creating community as part of whole campus efforts to enhance student experience and the overall quality of undergraduate education (Dewey, 1958). Dewey (1958) envisioned that students learn best through shared membership in the intellectual community. Efforts to enhance community can therefore help to prepare students as lifelong learners and as resilient and engaged citizens. “[There is an] opportunity to enhance the experience of campus life by influencing the development of higher education culture that understands psychosocial determinants of well-being and seeks to create conditions that cultivate well-being in students and staff ” (Oades et al., 2011 p. 433). Reducing Undue Stress Stress has been commonly cited as one of the top factors that negatively impacts student well-being, as well as student academic success (ACHA, 2010; Cotton et al., 2002; Robotham & Julian, 2006). Although moderate levels of stress can be associated with constructive involvement in learning, higher levels of stress can hinder learning and can negatively affect students’ emotional health (Swaner, 2005). “Whilst learning in university should entail challenge, it need not entail excessive stress – students will not perform at their best if they are unduly stressed” (Burgess, Anderson & Westerby, 2009, p.1). Stress impacts the body by engaging the sympathetic nervous system in a fight or flight response. Our bodies have evolved to respond to periods of heightened stress by focusing the body’s energy on basic survival and the reflexive systems within the brain and body which support this. As energy is redirected to those systems it is directed away from the pre-frontal cortex and other higher level thinking mechanisms in the brain (Stixrud, 2012). In this way, stress can impact a person’s ability to process information and resulting in negative impacts on learning. Both acute and chronic stress can impact negatively 3 Well-being in Academic Settings www.sfu.ca/healthycampuscommunity/academic-settings HEALTH PROMOTION on creativity, flexibility and adaptability (Stixrud, 2012). High levels of distress can also negatively impact student experience and satisfaction leading to withdrawal or disengagement (Cotton et al., 2002; Whitman, Spendlove & Clark, 1986). Student stress has been linked to emotional, cognitive, behavioural and physiological reactions including anxiety, depression, abuse and smoking and in some rare instances, student stress has even been linked to suicide (Robotham & Julian, 2006). Experiences of stress may be limiting students’ development of the very skills they will need for success in the 21st century including creativity, critical thinking and collaboration. In a recent review of the literature on stress in higher education, Robotham and Julian (2006) acknowledge that the prevalence of stress is increasing among higher education students. In the most recent National College Health Assessment Data, 81% percent of SFU students report feeling exhausted (not from physical activity), 83% felt overwhelmed by all they 8 had to do and over 50 % reported overwhelming anxiety at least once in the last 12 months (ACHA, 2010). In a Canadian cohort of the National College Health Assessment, students consistently reported that stress is the top factor that negatively impacts their academics (ACHA, 2013). In addition, 54% of students reported that their academic experiences within the past 12 months had been traumatic or very difficult to handle (ACHA, 2013). It is of central importance that higher education institutions continue to challenge students to do their best work while at the same time ensuring levels of stress are not negatively impacting student productivity, learning and well-being. In considering how learning experience may contribute positively or negatively to student experiences of stress it is important to consider the dynamic interplay between stressors and supports. Experiences that provide a balance between pressure, control and support encourage students to experience their academics as engaging as opposed to overwhelming (Cotton et al., 2002). Academic policies, processes, services, personal interactions, physical spaces and learning experiences can all be designed in ways that minimize unnecessary stress by enhancing a sense of support, flexibility, respect and mutual understanding. One of the most important factors that meditates an individual’s reaction to a stressor, and increases the likelihood that it will be perceived as a positive stressor or challenge rather than a negative stressor is the level of support they perceive (Cotton et al, 2002; Karasek, 1998) and the strength of their social networks (WHO, 2005). When examining stress and student job design, Cotton et al. (2002) found that levels of psychological distress were linked to the classroom environment: specifically high pressure, low control and low support from students and faculty. Whitman et al. (1986) found that “given the opportunity to participate actively in the learning process [students] report less stress than those forced into a more passive or helpless mode”. Theoretically, acting within this environmental context should reduce stress and enhance learning, satisfaction and well-being (Cotton et al., 2002). Although some stress is a necessary part of the student experience, there is significant evidence that high levels of stress can negatively impact academic success (Robotham & Julian, 2006). There is also evidence that current stress levels among higher education students is negatively impacting performance and student success (ACHA 2010; 2013). As described above, when students experience a balance between pressure, control and support they are more likely to experience their academics as engaging and challenging in a positive way as opposed to overwhelming (Cotton et al., 2002). Opportunities for Personal Development Whole student development is a term that is often used to refer to the development of students’ capacities and skills in relation to personal, professional and civic learning with the objective of developing students as whole 4 Well-being in Academic Settings www.sfu.ca/healthycampuscommunity/academic-settings HEALTH PROMOTION people who are resilient and engaged citizens, prepared for the challenges of today’s workforce (Harwood, 2014; Keeling, 2014). An opportunity exists to enhance student’s personal development not only in academic realms, but also in professional, personal and civic realms. Efforts to increase whole student development include providing students with experiences that enhance personal, social and civic skills. Enhancing personal and social skills within learning experiences has been associated with enhanced resilience, balance, self-esteem, social connectedness and engagement as well as decreased stress and anxiety (Cohen, 2006). Evidence suggests that these skills and capacities are associated with both physical and mental health benefits over one’s lifetime (Foresight Mental Capital and Wellbeing Project, 2008; Hammond, 2004). In addition, evidence from positive psychology indicates that developing skills which support a strong sense of autonomy, connectedness and competence contribute to psychological resilience and well-being as well as motivation and engagement (Ryan & Deci, 2000). It is important to note that the experiences and opportunities that contribute to whole student development occur both within and outside of the traditional classroom within higher education settings. Because students spend a large percentage of their time in classes and on course work for classes, the experiences they have within these settings are important for their personal and civic development (Hammond, 2004). Actions to enhance personal growth and development can include opportunities for real life and experiential learning, opportunities to connect with mentors or opportunities to network with professionals within the field. In addition opportunities to learn professional skills or develop personal competencies related to teamwork, intercultural competency, networking, or leadership can be incredibly beneficial for students’ success both at university and beyond. Opportunities or actions that help to build students’ sense of confidence and optimism related to their career opportunities are highly beneficial as are opportunities to build personal and professional skills that will serve them in their futures. These actions help to build students’ self-esteem, sense of competence and future optimism all of which are associated with long term well-being. As students gain confidence they also become increasingly autonomous and self-directed, skills which will serve them in their future success. Within the higher education sector, providing opportunities to enhance personal development is not only beneficial for well-being but it also supports students to learn skills that will benefit them in their future careers and become adaptable and resilient members of the workforce. Strengthening Balance and Resilience Strengthening balance and resilience is about providing students with the tools, resources and opportunities to maintain optimal health and well-being. Increasing students’ personal resources is important for overall well-being for a number of reasons. Firstly, developing personal resources and skills will help students to manage stress, maintain healthy lifestyle behaviours and succeed with their learning and academic goals. Secondly, capacities such as self-esteem, resilience, balance and social connectedness are considered determinants of various health outcomes including depression, anxiety, heart disease and overall quality of life (WHO, 2005). In terms of enhancing mental well-being specifically, opportunities for enhanced social and emotional growth help students develop personal resources that are protective of future mental health outcomes. Similarly, the positive emotions that result from strengthening resilience and balance are themselves determinants of happiness and overall wellbeing (Friedrickson, 2004). Within higher education settings, various strategies and opportunities can contribute to enhanced resilience and balance. These can include both on and off campus experiences as well as experiences built into the curriculum itself. Opportunities exist to educate students about strategies for enhancing their own 5 Well-being in Academic Settings www.sfu.ca/healthycampuscommunity/academic-settings HEALTH PROMOTION resilience and balance, while also creating environments that encourage balance, resilience and well-being. At an individual education level, actions may focus on strengthening capacity for health while building social and emotional skills and resilience among students and faculty members. As described above, enhanced resilience can also be facilitated by action to create supportive environments through changes to policies, processes, services, learning environments and physical spaces. This can include making alterations to policies or programs in ways that create positive social and physical environments, encourage healthy choices, and make balance and resilience an easier and more accessible choice. Inclusivity Inclusivity is about ensuring equity, safety and a sense of inclusion for all members of our campus community. Health is impacted not only by our physical condition and physical health status but also by the social determinants of health which include factors such as gender, ethnicity, income level, food security and disabilities. These factors can create health inequities within the campus community which make certain student groups vulnerable to health issues and concerns. In order to address these health inequities it is important to explore what special considerations can be made to provide extra support and resources to vulnerable populations. Within the higher education environment there are diverse student groups who should be considered when focusing on creating health equity. These include student groups who are known to experience additional challenges and transition issues including international students, indigenous students, students with disabilities, English as an Additional Language students, transgender students and students with mental health challenges. One important action that can be taken to improve health equity is creating inclusive environments. Creating inclusive environments can involve creating supports, services or accommodations that enable increased access and involvement among diverse students as well as exploring how policies, processes, or programs may be unintentionally excluding certain student groups from full participation. To enhance health equity and create inclusive environments, it is important to include perspectives from diverse students in planning and programming. There are therefore opportunities to reach out to diverse students through the Centre for Students with Disabilities, Indigenous Students’ Centre, International Services for Students and other campus clubs, programs and services to understand barriers to access and listen to their perspectives on how to enhance equity, access and inclusion. Our campus communities are becoming increasingly diverse, and this diversity should be seen as a resource for strengthening community resilience. Inclusivity has an important and direct impact on overall health and well-being and has been widely shown to be correlated with improved health outcomes and resilience at both an individual and community level (Cooke et al., 2011; WHO, 2005). Inclusivity is well understood as a determinant of mental health and well-being, as it impacts on experiences of isolation, belonging and connection (WHO, 2005). Social inclusion can also impact on access to services, social supports and participation all of which relate to students’ overall success and well-being. It is important to consider the varying levels of vulnerability within the student population so as to help reduce health inequalities within the student population. Involvement and Engagement Through community involvement, participation and civic engagement, students and faculty members develop increased skills and competencies and feel part of a larger community. In the field of community health promo6 Well-being in Academic Settings www.sfu.ca/healthycampuscommunity/academic-settings HEALTH PROMOTION tion, this is referred to as community capacity building, and it has been shown to have multiple benefits for individuals and communities (Crisp, Swerissen & Duckett, 2000). As community members gain skills, and personal competencies through participation, their sense of confidence, self-esteem and resilience increase as well as their social support networks and sense of connectedness. As described above, these intermediate measure are all linked with long term well-being (Foresight Mental Capital and Wellbeing Project, 2008; Hammond, 2004). Participation can also build professional confidence and skills which support a successful transition to the workforce and reduce student anxieties regarding their next steps following graduation. In addition, student participation and involvement within the institution leads to social and school connections which are also beneficial for wellbeing (Rowe et al., 2007). Student involvement and engagement may be particularly important among vulnerable groups as their participation can not only increase social inclusion and connection but also provide an avenue for advocacy and attention to the diverse needs of students and the barriers that prevent some students from full participation and inclusion. Student voice is an essential feature of a healthy campus community and including student perspectives in decision making can increase the sense of mutual trust and understanding within the institutional culture, while also enabling the identification of opportunities for positive change, and encouraging students themselves to build skills for civic participation and engagement. Civic engagement and participation can also lead to an increased sense of contribution which is also beneficial for well-being. 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