Presentation Objectives

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1 The Short-Term Effects of a Wellness On-boarding Program with Health Sciences Students on Depression, Anxiety, Healthy Lifestyle Beliefs and Healthy Lifestyle Behaviors Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FAAN Caitlin Slevin, MHA, BS, CCRP Lisa Militello, PhD, RN, PNP Jacqueline Hoying, MS, RN, NEA-BC Colleen McGovern, BSN, RN Alice M Teall, MS, FNP, PNP Laura Szalacha, EdD

2 Presentation Objectives Learner Objective 1: Describe short-term effects of a wellness program on health sciences students depressive and anxiety symptoms, healthy lifestyle beliefs, and healthy behaviors. Learner Objective 2: Discuss clinical and research implications from this study.

3 Transition into Graduate School Can be a Stressful Time for Many Students

4 Background First year health sciences students are subject to high stress levels as they enter their professional programs. Although academic programs prepare students to deliver excellent care to their patients, few incorporate wellness programs and self-care into their curricula.

5 Purpose To evaluate the feasibility, acceptability and preliminary short-term effects of a wellness on-boarding program for health sciences students, including dentistry, health and rehabilitation sciences, medicine, nursing, optometry, pharmacy, and veterinary medicine, on their healthy lifestyle beliefs, healthy lifestyle behaviors, depressive symptoms and anxiety four months after the intervention.

6 Methods A pre-experimental study was conducted with 93 health sciences students entering their health professional programs at a major public land grant university in the mid-west region of the U.S. Two to 4 weeks after starting the first semester, students completed a personalized wellness assessment, a biometric screen that included height, weight, blood pressure, Hemoglobin A1c and lipid panel, and developed a personalized wellness plan.

7 Methods Continued Valid and reliable measures were collected at the start and end of the students first semester (December, 2014) Patient Health Questionnaire-9 (PHQ-9) for depression The Generalized Anxiety Disorder Scale (GAD-7) The Brief Inventory of Perceived Stress (BIPS) The Healthy Lifestyle Beliefs Scale The Healthy Lifestyle Behaviors Scale

8 Demographics Demographic Variable N Percent of Sample Enrolled College of Enrollment Dentistry 7 8% Health and Rehabilitation 11 12% Medicine 35 38% Nursing 19 20% Optometry 3 3% Pharmacy 16 17% Veterinary Medicine 2 2% Gender Male 30 33% Female 60 66% Ethnicity White, Not of Hispanic Origin 77 83% Black, Not of Hispanic Origin 3 3% Asian or Pacific Islander 11 12% Hispanic 2 2%

9 Results: Biometric Screening at Baseline Body Mass Index N T1 Mean (SD) Male (3.40) Female (5.89) Biometric Measures N Cholesterol Mean (SD) N HDL Mean (SD) N Non-HDL Mean (SD) N Systolic Mean (SD) N Diastolic Mean (SD) N A1c Mean (SD) Male (35.20) (7.59) (34.20) (10.77) (9.90) (.212) Female (34.94) (14.25) (30.70) (9.79) (9.21) (.178)

10 Results Biometric Screening at Baseline BMI Group N % Underweight % Normal % Overweight % Obese Class I % Obese Class II % Obese Class III %

11 Results Biometric Screening at Baseline Cholesterol N % Less than 180 mg/dl % mg/dl % 200 mg/dl and over %

12 Results: Anxiety and Depression Anxiety Classification T1 %(N) Depression Classification* T1 % (N) Less than 5 points 66.7 % (48) Less than 5 points 59.1% (55) Mild Anxiety (5-10) 29.2% (21) Mild Depression (5-10) 32.3% (30) Moderate Anxiety (10-15) 4.2 % (3) Severe Anxiety (15+) 0 %(0) Moderate Depression (10-15) 3.2%(3) Moderately Sever Depression (15-20) 2.2% (2) Severe Depression (20+) 3.2 (3) *4 of the students reported suicidal ideation on the PHQ-9

13 Results Continued Findings from Baseline (T1) to End of First Semester (T2) Mean Score Change N T1 Mean (SD) T2 Mean (SD) Mean Change Score p-value Healthy Lifestyle Beliefs (6.76) (6.50) Healthy Lifestyle Behaviors (7.06) (6.90) ** PHQ (4.54) 4.48 (4.45) GAD (3.72) 3.94 (3.73) BIPS (5.84) (5.53)

14 Implications for Practice and Research Entering health professional students should be screened for anxiety and depression, and those with elevated symptoms should be evaluated further and offered evidence-based interventions Students should know their biometric screening numbers Personalized wellness assessments, biometric screens and creation of a personalized wellness plan are not enough to facilitate healthy lifestyle behavior change There is a need for more intervention studies with this population of health sciences students who are at risk for adverse physical and mental health outcomes during graduate school

15 Risk Factors and Their Relationships with Medical Conditions (darker lines indicate a stronger relationship) Bolnick, H., Millard, F. & Dugas, J.P. (2013). Medical Care Savings From Workplace Wellness Programs What Is a Realistic Savings Potential? Journal of Occupational and Environmental Medicine, 55(1), 4-9.

16 Contributors to Premature Death Health Care 10% Environmental Exposure 5% Social Circumstances 15% Behavioral Patterns 40% Genetic Predisposition 30%

17 Based on Evidence What Do We Know? People who have the following behaviors have 66% less diabetes, 45% less heart disease; 45% less back pain, 93% less depression, and 74% less stress Physical activity- 30 minutes 5 days per week Healthy eating- 5 fruits and vegetables per day No smoking Alcohol in moderation- 1 drink per day for women, 2 drinks per day for men

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