Wellness factors in first year college students.

Abstract: One of the priorities for college campuses is an emphasis on promoting healthy behaviors. To assess health promotion behaviors of college students the Wellness Evaluation of Lifestyle (WEL) was used. Students in this study scored highest on the WEL subscales of love (85.64 out of 100) and sense of worth (83.81 out of 100) and lowest on the nutrition (67.16 out of 100) and stress management (73.48 out of 100). Comparison to national norms indicates significant differences on several of the scale scores. Implications for current practice and future research are discussed in relation to the findings.

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One of the priorities for college campuses according to Healthy Campus 2010 is an emphasis on promoting healthy behaviors (American College Health Association, 2004). Assessing the health promoting behaviors of college students should be the first step in identifying prevention strategies that will create healthy campuses. Research related to wellness behaviors has the potential for impacting large numbers of students in the college environment, as according to the Bureau of Labor Statistics, over 10.8 million students were enrolled in college during 2004. By focusing on promoting the healthy behaviors initiated in college, health professionals can assist students in sustaining these behaviors over their lifetime.

The World Health Organization (WHO) has developed a widely used definition of wellness which includes physical, mental and social well-being (WHO, 1964). This holistic view of wellness encompasses many variables such as spirituality and emotional health, as well as physical health in describing individual well-being (Myers, Sweeney, & Witmer, 2000). Multiple studies have examined specific aspects of health and health behaviors to determine their impact on well being. These studies include scrutiny of spirituality (Bowen-Reid & Harrell, 2002; Hawks, Goudy, & Gast, 2003; Trockel, Barnes, & Egget, 2000), love (Khaleque, 2004; Sanderson & Cantor, 1997), sense of worth (Crocker, Luhtanen, Cooper, & Bourette, 2003; Hafen, Frandsen, Karren, & Hooker, 1992; Herrero & Grocica 2004), nutrition (Cousineau, Goldstein, & Franko, 2004), exercise (Insel & Roth, 2005), and stress management (Hudd et al., 2000; Kim & Seidlitz, 2002; Thome & Espelage, 2004). Unhealthy behaviors, such as eating more junk food and not exercising, have been related to higher levels of stress (Hudd et al., 2000). Hudd reported that 52.1% of college students indicated relatively high levels of stress. The students in this study also indicated that over the past 24 hours they had somewhat unhealthy eating habits. Results of a 2006 health risk survey of college students indicated 33% of these students reported that stress negatively impacted their academic success and 60.4% drank more alcohol than intended (Reagan, personal communication, March 6, 2006). The low rate of exercise is a major health concern in the United States. The ACHA (2005) reported only 44.2% of students exercised vigorously for at least 20 to 30 minutes on at least 3 of the past 7 days.

While these studies are important in documenting the impact of individual factors on the health and well-being of college students, there is limited research describing the impact of multiple, concurrent behaviors on wellness in the college population. Previous studies focused on wellness using the written WEL (Herman & Davis, 2004) found significant differences between traditional and non-traditional students on the self-regulation scale of the WEL instrument. Myers and Mobley (2004) found lower levels of wellness in both traditional and non-traditional college students compared to non-student adults when using the revised version of the of the WEL instrument. Additionally, Hey, Calderon, and Carroll (2006) recently developed the Body-Mind-Spirit Wellness Behavior and Characteristic Inventory to measure wellness behaviors and characteristics for college students. No previous studies using on-line surveys measuring overall wellness were found.

Myers et al. (2000) developed the Wellness Evaluation of Lifestyle (WEL) as a method for describing wellness behaviors that encompass factors related to the body, mind, and spirit. The WEL evaluation of lifestyle instrument was designed to identify wellness behaviors encompassing both the physical as well as the psychological dimensions of behavior. To examine healthy behaviors of the college population, this study focused on six of the subscales of the WEL instrument including spirituality, sense of worth, nutrition, exercise, stress management, and love. With the increased emphasis on health promotion and wellness, further research is needed to identify wellness behaviors in college students.

The following research questions were developed to explore wellness behaviors of first year college students: What are the wellness behaviors in first-year college students? How do the wellness scores of this sample of first year college students compare with scores from a national sample of college students?

METHOD

The sample consisted of 1007 (n = 535 women, n = 470 men, with gender data missing for 2 participants) first-year students enrolled in a one-credit required general education course, Skills for Healthy Living, in two moderate-sized, Catholic, Midwest, liberal arts colleges. Students ranged in age from 18-20 years. This course was only offered to first year students. All first-year students in 2002-03 completed the WEL as a course requirement, 100% participation was achieved. The study was reviewed by the institutions' human participants committee and approved with an expedited review.

An on-line version of the WEL survey was purchased and formatted for on-line use by the institutions to simplify collection and evaluation of data. (Mindgarden, 2005). All first year students completed the WEL survey on their own time during the first week of the course by entering data directly into the on-line data base. The WEL scale scores were calculated by student-workers and returned to participants via e-mail. Statistical analyses including Cronbach's alpha coefficients, and descriptive and comparative statistics on the data were completed using the Statistical Package for Social Sciences (SPSS) 12.0.

Wellness was measured using the Wellness Evaluation of Lifestyle (WEL), a 123 item survey using a five point Likert-type scale (Myers, Sweeney & Witmer, 2000). Wellness is measured by 17 subscales consisting of five life tasks. Previous-use reliabilities indicate internal consistency of the 17 subscales ranged from .61 to .89 (Myers et al.). The Cronbach's alpha's for this study ranged from .43 (sense of control scale) to .82 (exercise scale) with a total alpha of .88. Only those subscales with Cronbach's alpha at or above .70 are addressed in this study; these include Total Wellness (.88), Love (.80), Sense of Worth (.73), Exercise (.82), Spirituality (.82), Stress Management (.79) and Nutrition (.78).

RESULTS

Descriptive statistics for the sample of first year college students are reported in Table 1. The results from descriptive analyses indicated that students from this sample scored highest on the love (85.64 out of 100) and sense of worth (83.81 out of 100) subscales and lowest on the nutrition (67.16 out of 100) and stress management (73.48 out of 100) subscales.

The only national, normative, comparative data for the WEL was compiled with 1,357 participants age 19-25 (Hattie, Myers & Sweeney, 2004). Table 1 compares the average scores from this sample of first year students on selected subscales to the average scores for the national normative sample; p values at .05 or less were considered significant in this study. A power analysis was computed based on means and standard deviations for the study group and national sample, alpha of 0.05, the sample size of 1007 and the national sample size of 1357. The statistical power for this test was 84.7%.

DISCUSSION

The first purpose of this study was to explore wellness behaviors of first year college students. The on-line administration of the WEL instrument was very effective in collecting wellness data for this group of first year college students; all first year students participated in the survey and completed information was available for all but two students. Advantages to the on-line administration of this survey included ease of calculation of scores and return of results. Additionally, this group of students was computer literate and worked with computers on a daily basis making completion of the survey very convenient.

This sample of students scored highest in the love and sense of worth subscales from the WEL. Love was assessed by eight questions related to having at least one relationship which provided physical and emotional intimacy. The high scores in this dimension possibly reflect the importance of social connections in this group of students. According to Reagan and colleagues (personal communication, March 6, 2006) a majority of students on these college campuses, 46.9%, reported having had no sexual partners. Because of the low incidence of sexual relationships, higher love scores may reflect non-sexual friendships or close family ties for this group of students. The higher sense of worth ratings may be related to the increased love ratings for these students. Sense of worth included five questions related to accepting and valuing both the self and genuine relationships with others. When students have a high sense of worth, they feel good about themselves, and are more likely to have positive relationships which reflect higher ratings in the love dimension (Hafen et al, 1992).

Student scores on the nutrition and stress management subscales were lower than other WEL scores reported in this study. The nutrition dimension was evaluated with five questions related to satisfaction with the variety and amount of food eaten daily. Students struggle with nutrition as they transition to a more independent lifestyle. Factors such as variety of cafeteria food choices, hours of operation of cafeterias, cost of food choices, and increased snacking used as a coping strategy for stress (Hudd et al., 2000) all impact the nutrition scores. These low scores indicated the importance of addressing nutrition issues in the college population.

Being able to recognize and positively cope with stress was addressed in the eight questions of the stress management subscale. College students must constantly balance the demands of the classroom with work, extracurricular activities, volunteerism and social life (Kim & Seidlitz, 2002; Thome & Espelage, 2004). First year students, like those in the current study, suddenly away from family, friends and familiar ways of coping with stress were transitioning to new strategies to manage stress. This transition was reflected in the stress management scale scores.

The second purpose of this study was to compare WEL scores of these first year students to a national sample. The only available national normative data for the WEL was compiled with 1,357 participants (Hattie et al., 2004). The first year college students in this sample had significantly higher mean scores related to exercise, stress management and nutrition when compared with a national sample. These results may be related to the age of the study group. This group of students ranged in age from 18-20 while the national sample ranged in age from 19-25. Myers & Mobley (2004) have reported on the significant differences for traditional versus non-traditional college students. Because of routines established and monitored in high school and home, first year students may be more likely to continue with exercise, stress management and nutrition habits when compared with those students in later college years and younger adulthood. For young adults ages 19 to 25, as in the national norm group, limited time can become an issue with juggling varied work and family responsibilities and can have a negative impact on stress management, nutrition and exercise patterns.

On both the love and spirituality subscales, the students in this sample scored lower than the national norm. As mentioned previously, first year students were away from family and high school friends for perhaps the first time and this could have had an impact on the closeness these students felt to significant others. These first year students may not have had the opportunity to develop committed relationships with significant others in the college setting. The lower comparative spirituality score may also be related to students leaving home and these students who, away from their families, had the opportunity to question their beliefs and discover alternative faith traditions.

The unique institutional setting for this sample, including the religious affiliation and cooperative structure of the two colleges, make generalizations of these findings difficult. Also, due to the broad conceptualizations of wellness it is difficult to consistently and completely measure wellness and relate findings across studies. The lower alpha reliability scores on several of the WEL subscales make a complete analysis of wellness behaviors in this sample of students particularly difficult. The low subscale reliabilities in this sample are consistent with previous studies using the WEL (Myers et al, 1998). Hermon and Davis (2004) studied wellness using the WEL in both traditional and non-traditional college students; they however do not report the reliabilities for their sample. Newer versions of the WEL instrument have been used in several studies with reliability data ranging from .60 to .83 (Myers & Mobley, 2004).

This study provided information about wellness factors reported in first year college students. Findings from this study could be utilized at the institutional level; colleges could explore how the campus academic and student affairs policies align with components of wellness (e.g. residential quiet hours, healthy food options in the dining room, quality exercise facilities). College faculty and staff could consider the development or expansion of wellness courses within the curricula, incorporating these findings into general class discussions, as well as development or expansion of wellness programming and services.

These findings also have implications for assisting individual college students. Assessing wellness in first year students may be particularly helpful to address needs of these students, build on strengths and apply individualized wellness interventions. College faculty and staff have a variety of formal (counseling, academic advising) and informal opportunities (residential life staff) to converse with students about their lives. Through these interactions they influence the environment for individual students; seeing faculty and staff investing in their personal wellness reinforces the message that wellness is a priority. On a remedial level, colleges could consider requiring wellness assessments and individual wellness plans for students on academic or judicial probation. By focusing attention on wellness behaviors of college students, health and education professionals can develop programs and activities to enhance wellness for college students, thereby impacting their success in college and assisting them in developing healthy behaviors that can be sustained over their lifetime.

ACKNOWLEDGEMENTS

The authors of this article wish to acknowledge the help and support of Dr. Kathleen Twohy, Chair, Department of Nursing and Linda Shepherd, Assistant Professor, Nutrition Department, College of St. Benedict/St. John's University.

REFERENCES

American College Health Association (2004). Health Campus 2010: Making it Happen. Baltimore, MD: American College Health Association.

American College Health Association (2005). The American College Health Association National College Health Assessment, Spring 2003 Reference Group Report. Journal of American College Health, 53(5), 199-210.

Bowen-Reid, T. & Harrell, J. (2002). Racist experiences and health outcomes: An examination of spirituality as a buffer. Journal of Black Psychology, 28(1), 18-36.

Cousineau, T., Goldstein, B., & Franko, D. (2004). A collaborative approach to nutrition education for college students. Journal of American College Health 53(2), 79-84.

Crocker, J., Luhtanen, R., Cooper, M., & Bouvrette, A. (2003). Contingencies of self-worth in college students: Theory and measurement. Journal of Personality and Social Psychology, 83(3), 894-908.

Hafen, Q., Frandsen, K., Karren, J., & Hooker, R. (1992). The health effects of attitudes, emotional relationships. Provo, UT: EMS Associates.

Hattie, J., Myers, J., & Sweeney, T. (2004). A factor structure of wellness: Theory, assessment, analysis and practice. Journal of Counseling and Development, 82, 354-364.

Hawks, S., Goudy, M., & Gast, J. (2003). Emotional eating and spiritual well-being: A possible connection? American Journal of Health Education, 34(1), 30-33.

Hermon, D. & Davis, G. (2004). College student wellness: A comparison between traditional- and nontraditional-age students. Journal of College Counseling, 7, 32-39.

Herrero, J. & Grocica, E. (2004). Predicting social integration in the community among college students. Journal of Community Psychology, 32(6), 707-720.

Hey, W., Calderon, K., & Carroll, H. (2006). Use of body-mind-spirit dimensions for the development of a wellness behavior and characteristic inventory for college students. Health Promotion Practice, 7(1), 125-133.

Hudd, S., Dumlao, J., Erdmann-Sager, D., Murray, D., Phan, E., & Soukas, N. (2000). Stress at college: Effects on health habits, health status and self-esteem. College Student Journal, 34(2), 217.

Insel, P. & Roth, W. (2005). Core Concepts in Health. New York: McGraw Hill.

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RESPONSIBILITIES AND COMPETENCIES OF HEALTH EDUCATION

Responsibility I--Assessing Individual and Community Needs for Health Education

Competency A: Obtain health related data about social and cultural environments, growth and development factors, needs, and interests

Competency B: Distinguish between behaviors that foster and those that hinder well-being

Competency C: Infer needs for health education on the basis of obtained data

Responsibility VIII--Apply Appropriate Research Principles and Methods in Health Education

Competency A: Conduct thorough reviews of literature

Competency B: Use appropriate qualitative and quantitative research methods

Janna LaFountaine, MS, is an Assistant Professor in the Department of Physical Education at College of St. Benedict / St. John's University. Mary Neisen, RN, MA, CNP, is a Clinical Instructor, in the Department of Nursing at College of St. Benedict / St. John's University. Rachelle Parsons, RN, PhD, is an Assistant Professor in the Department of Nursing at the College of St. Benedict / St. John's University. Please address all correspondence to Janna LaFountaine, 37 South College Ave., HCC 22B, College of St. Benedict, St. Joseph, MN 56374; PHONE: [phone]; FAX: [phone]; EMAIL: [e-mail].

Table 1. Descriptive and Comparative Statistics for the
WEL Scale Items

                    Mean
                    Study Sample      Std.             Mean Nat'l
                    Group             Deviation        Norm Group
WEL Scale           (N=1007)          Sample           (N=1357)

Love                85.7              11.1             87.5
Sense of Worth      83.8              10.6             83.6
Exercise            79.8              15.3             72.8
Spirituality        73.7              12.8             75.8
Stress
Management          73.5              10.8             72.1
Nutrition           67.2              15.8             59.1

                    Std.
                    Deviation                          p
WEL Scale           Norm Group        t test           value

Love                13.6              3.55             <.01
Sense of Worth      12.8              0.42             0.67
Exercise            18.0              9.97             <.01
Spirituality        18.0              3.17             <.01
Stress
Management          14.7              2.52             <.05
Nutrition           20.3              10.47            <.01