1. 1 Health Impacts of Negative Academic Behaviors Matty Lehman, MSS LSW Tamarah Smith-Dyer, MS University of Pennsylvania Office of Health Education

2. 2 Presenters  Matty Lehman, MSS LSW  Associate Director, Office of Health Education  University of Pennsylvania  Tamarah Smith-Dyer, MS  Data Analyst, Office of Health Education  University of Pennsylvania

3. 3 Agenda  Office of Health Education, University of Pennsylvania  Definitions  NCHA background  NCHA academic impacts findings  PHWS background  NCHA academic impacts findings

4. 4 Office of Health Education  Staff  Susan Villari, MPH – Director  Matty Lehman, MSS – Assoc Director  Tamarah Smith-Dyer – Data Analyst  Steve McCann – Wellness Coordinator  Programs  Stress Reduction  Smoking Cessation  Peer Health  Sexual Health Programming

5. 5 NCHA- Background  ACHA’s National College Health Assessment  Comprehensive assessment including:  Alcohol, tobacco, and other drug use  Sexual health  Weight, nutrition, and exercise  Mental health  Personal safety and violence  Academic Impacts National College Health Association (2008).Retrieved May 18, 2009, from http://www.acha- ncha.org/partic_history.html

6. 6 NCHA- Background  Reference Group- Spring 2006  117 institutions, n=94,806 students  95% 4-year institutions  83% post-baccalaureate degrees  49% urban  22% suburban  32% rural  Self reported data* 6 American College Health Association. American College Health Association-National College Health Assessment: Reference Group Data Report Spring 2006. Baltimore: American College Health Association; 2006.

7. 7 Academic Impact Methodology  Health/wellness --> Academic performance 7 Key language: “...have any of the following affected your academic performance?”

8. 8 Academic Impact Analysis  Analysis examined: 1.What is the FREQUENCY OF SELF REPORTED ISSUES impacting academics? 2.Are students with a LOWER GPA MORE LIKELY TO REPORT:  these issues impacted their academics?  experiencing these health issues (regardless of academic impact)?

9. 9 FREQUENCY OF SELF REPORTED ISSUES  58% of student reported one or more of the TOP 6 HEALTH RELATED ISSUES impacted their academics: 1.PHYSICAL HEALTH (Cold/flu/soar throat) 2.STRESS 3.SLEEP DIFFICULTIES 4.INTERNET USE 5.MENTAL HEALTH 6.ALCOHOL USE 9

10. 10 Are students with a more likely to report these issues impacted their academics? Are students with a lower GPA more likely to report these issues impacted their academics?  Cross tabulating with reported GPA  Group One: A GPA  Group Two: Non-A GPA  69% of students with a Non-A GPA report one or more of the top six impacting their academics  The odds that this group will experience one or more of the top six issues is 2.5x higher than that of students with an A GPA (p<.05)

11. 11 Are students with a lower GPA more likely to report experiencing these health issues (regardless of academic impact)?  Using questions from other sections of the survey  Results show that students with a non-A GPA are significantly more likely to experience OF THE SIX TOP ISSUES impacting academics:  Results show that students with a non-A GPA are significantly more likely to experience FOUR OF THE SIX TOP ISSUES impacting academics:  Physical health problems  Depression, Anxiety and/or SAD  Stress  Sleep difficulties

12. 12 NCHA Findings- Summary  58% of students report one or more of top six health concerns impact academics  Those students with a non-A GPA are  significantly more likely to report these academic impacts  significantly more likely to report 4 of the 6 issues when unrelated to academics

13. 13 Remaining Question  Direction of relationship  Poor health makes it difficult to perform academically  OR  Something happens during the academic process that impacts health.  The Penn Health and Wellness Survey (PHWS) examined the “something” that may happen during the academic process and its impact on health.

14. 14 PHWS- Background  Assesses similar areas as NCHA  Web-based  Launched spring 2008 (n=3025)  Split into three sub-surveys to allow for more comprehensive range of questions

15. 15 PHWS- Background  Additional questions to provide  Penn specific data  More detail Ex: Penn Specific Have you been tested for HIV Have you been tested for HIV Where were you tested Where were you tested Reason for choosing location Reason for choosing location Interest & willingness to use various locations Interest & willingness to use various locations Ex: More Detail Sexual Health Sexual Health Three sections: Oral, Vaginal & Anal Sex Three sections: Oral, Vaginal & Anal Sex Skip patterns provide questions Skip patterns provide questions for each section

16. 16 Academic Impacts Methodology  Methodology:  Reverse order academics  wellness  Add compensation behaviors- the something that happens during academics  Academic behavior --> Compensation --> Health/wellness 16 Unhealthy academic behaviors Compensation behaviors Poor health

17. 17 Academic Impacts Methodology ‘ UNHEALTHY ACADEMIC BEHAVIORS Poor time management Skipping class/going to class late Not contributing to group projects Not completing readings or assignments Missing exams IMPACTS ON WELLNESS Physical health Mental health Anxiety Stress Sleep difficulties Nutrition Under exercised Over exercised Limited time with friends COMPENSATIONS FOR POOR BEHAVIORS Stayed awake all night to get work done, etc. Did not hand in best work Copied work, paid or exchanged work Compromised other school work Canceled appointments (medial, counseling, etc) Took AD/HD medications

18. 18 Academic Impacts Analysis 1.What is the FREQUENCY OF COMPENSATION behaviors 2.Did COMPENSATION behaviors IMPACT HEALTH/WELLNESS 18

19. 19 FREQUENCY OF COMPENSATION BEHAVIORS  59% of students compensated for unhealthy academic behaviors in some way  Top Compensations: 1.STAYING AWAKE 2.SKIPPING PERSONAL/SOCIAL EVENTS 3.NOT COMPLETING READINGS 4.NOT HANDING IN BEST WORK 5.SKIPPING CLASS 6.SKIPPING MEALS

20. 20 IMPACT OF COMPENSATIONS ON WELLNESS  Students who compensated for unhealthy academic behaviors were significantly more likely to report all measures of wellness being impacted. Nutrition Under exercised Over exercised Limited time with friends Physical health Mental health Anxiety Stress Sleep difficulties

21. 21 Summary  A significant relationship between wellness and academics exists  Poor health impacts academics  Compensations for poor academic behaviors impact health

22. 22 Cyclic Relationship 22 Unhealthy academic behaviors Compensation behaviors Poor health Academic Impacts Poor time management Stay up all night to get work done Get sick Miss class and hand in assignment late Now, grade is lower & too sick to stay up Take AD/HD to stay up to work on projects Sleep is disturbed Mental health is impacted Do poorly on exam

23. 23 Points of Intervention 23 Unhealthy academic behaviors Compensation behaviors Poor health Academic Impacts Health Education Health Services Behavioral Intervention Learning Resources Faculty outreach INTERVENTIONS

24. 24 Some OHE Interventions: Social Marketing

25. 25 Behavioral Intervention Some OHE Interventions: Behavioral Intervention  Smoking Cessation  Individual sessions  Trained counselor  Multiple modalities  Goal oriented  Comprehensive health considered  Stress Reduction  (w/ alternative therapies)  Individual sessions  Alternative therapies

26. 26 Contact Info University of Pennsylvania Office of Health Education 3611 Locust Walk, 3 rd Floor Philadelphia, PA 19104 215.573.3525 Matty Lehman, LSW lehman2@upenn.edu Tamarah Smith-Dyer tamarahf@upenn.edu