Wellness: A Review of Theory and Measurement for Counselors

Sense of Happiness and Wellness Among Adolescents and Their School Environment

BACKGROUND

Happiness and health are crucial elements of adolescents' lives that significantly impact mental well-being and societal engagement. This article hypothesizes that a suitable school environment may be one of the components that can impact students' subjective feelings of happiness and health. This research aimed to determine the association between a negative school environment, such as experiencing bullying and feeling insecure at school, and students' happiness and health.

METHODS

The study was conducted in 2023, surveying students in grades 7-10 from two Lithuanian cities and their districts. The study included 1992 students (females 50.2%) with a mean age of 14.53 ± 1.12.

RESULTS

It was observed that male students felt healthier and happier than females. Also, male students felt safer at school more often than females. A positive correlation was found between a student's feeling of safety at school and their happiness and health. Regression analysis revealed that a feeling of safety at school was the most significant positive factor associated with male students' sense of happiness and health. Also, the most important factors for females were a feeling of safety at school, bullying, and how often teachers stop bullying.

CONCLUSIONS

It was found that feelings of insecurity at school, experiences of bullying, and how often teachers stop bullying can be associated with students' subjective feelings of happiness and well-being. School environmental factors can affect students' happiness and well-being differently depending on gender. It is essential to focus on vulnerable student populations when creating preventive programs to enhance adolescents' sense of safety in schools.

"This Is What You Get When You Lead with the Arts": Making the Case for Social Wellness

Like other key terms in the medical and health humanities-empathy, creativity, and reflection, to name just a few-wellness has become a weasel word, rife the language of optimization, duty, and self-perception. While alternative vocabularies exist-well-being and quality of life among them-these options usually privilege the objectives of academic (often psychological) research, health institutions, and the economic state apparatus, rather than people themselves. In mind of these concerns, why attempt to make a case for wellness at all? We present a historically informed, theoretically driven, praxis-guided framework for a renewed vision of social wellness (a concept first defined in the late 1950s). While definitions since Bill Hettler's "hexagonal" model (1980) have included mutual respect for others and the assumption of cooperative behaviors, conspicuously absent from contemporary definitions and usage is any mention of the aesthetic realm, which we-alongside philosophers like Amartya Sen and Martha Nussbaum-take as a central human capability. How can the relational possibilities of arts engagement be understood as not just a means of promoting individual wellness, but also as a method and outcome of social wellness? We propose that social wellness is ultimately premised on the interplay between wellness of the collective and the strength of the relational encounters it engenders. We turn to a key practice paradigm-community arts engagement-as both a vehicle for and site of social wellness. With brief reference to a Canadian exemplar, we conclude with concrete recommendations for addressing critical opportunities for advancing arts-led social wellness initiatives involving academic and community partners.

Well-being as Need Fulfillment: Implications for Theory, Methods, and Practice

The most prominent concept championed by human resource professionals, point solution providers, and the mental health care industry is the construct of holistic well-being. Despite the tremendous attention focused on well-being, the concept lacks theoretical consensus among its proponents. Like the concept of engagement, this field cries out for clearly stated definitions that embed the concept within a theoretical framework, allowing theory development to avoid the prolific category errors of the past 50 years. This paper argues for a more sophisticated approach to the concept of well-being, grounding it in the vast psychological literature on human motivation. Herein lies the contribution of our paper; we argue that the apparent diversity of operational definitions employed by academics and practitioners can be understood as tentative attempts to draw ever nearer to key motivational concepts, without ever quite getting there. We review the leading definitions of well-being in the literature and find that they are reducible to a core set of human motives, each backed by full research traditions of their own, which populate a comprehensive model of twelve human motivations. We propose that there is substantial value in adopting a comprehensive motivational taxonomy over current approaches, which have the effect of "snowballing" ever more dimensions and elements. We consider the impact of setting well-being concepts in existing motivational constructs for each of the following: (a) theory, especially the development of well-being frameworks; (b) methods, including the value of applying a comprehensive, structural approach; and (c) practice, where we emphasize the practical advantages of clear operational definitions.

A Longitudinal Multi-Method Inquiry of Educational Workers' Use of Interventions for Positive Mental Wellbeing

BACKGROUND AND OBJECTIVES

Compassion fatigue and burnout are two distinct forms of mental health distress faced by educational workers. Researchers have shown a high level of both phenomena across the field of education; however, a better understanding of what educational workers already do for positive mental and emotional health is needed.

METHODS

This research study examined three years of data, collected via survey, inquiring into the various interventions, namely supports and resources, that educational workers use to support positive mental health.

RESULTS

Quantitative data analysis via descriptive and inferential statistics revealed that educational workers relied heavily on their personal support network followed distantly by medical professionals and other interventions, revealing a gap that needs to be addressed by employers. Qualitative thematic analysis revealed a trend towards increased use of environmental interventions to promote positive mental wellbeing.

CONCLUSIONS

The data analysis suggested areas of focus required to ensure workplace wellbeing, and that programs too focused on individual or self-directed interventions would not be well received by educators. Suggestions for other interventions that might be helpful for leaders and policy-makers are provided.

Meeting people where they are: Crowdsourcing goal-specific personalized wellness practices

OBJECTIVES

Despite the development of efficacious wellness interventions, sustainable wellness behavior change remains challenging. To optimize engagement, initiating small behaviors that build upon existing practices congruent with individuals' lifestyles may promote sustainable wellness behavior change. In this study, we crowd-sourced helpful, flexible, and engaging wellness practices to identify a list of those commonly used for improving sleep, productivity, and physical, emotional, and social wellness from participants who felt they had been successful in these dimensions.

METHOD

We recruited a representative sample of 992 U.S. residents to survey the wellness dimensions in which they had achieved success and their specific wellness practices.

RESULTS

Responses were aggregated across demographic, health, lifestyle factors, and wellness dimension. Exploration of these data revealed that there was little overlap in preferred practices across wellness dimensions. Within wellness dimensions, preferred practices were similar across demographic factors, especially within the top 3-4 most selected practices. Interestingly, daily wellness practices differ from those typically recommended as efficacious by research studies and seem to be impacted by health status (e.g., depression, cardiovascular disease). Additionally, we developed and provide for public use a web dashboard that visualizes and enables exploration of the study results.

CONCLUSIONS

Findings identify personalized, sustainable wellness practices targeted at specific wellness dimensions. Future studies could leverage tailored practices as recommendations for optimizing the development of healthier behaviors.

Well-being balance and lived experiences assessment: a valid, comprehensive measure of positive well-being

Introduction

Widely used measures of self-reported subjective well-being and flourishing generally do not directly measure positive experiences that have been demonstrated to improve subjective well-being and flourishing, which could aid in developing personalized interventions to improve individuals' well-being. The present study evaluated the validity of the Well-being Balance and Lived Experience (WBAL) Model and Assessment, a new model of well-being and corresponding assessment instrument that evaluates the self-reported frequency of positive experiences and positive feelings of well-being, balanced across activation and arousal levels.

Methods

A total of 496 evaluable subjects completed the WBAL Assessment, the PERMA+ Profiler (PERMA+) and the Well-Being Assessment Adult 24-item (WBA-24). A confirmatory factor model corresponding to the WBAL construct was created, and internal and external validity of the WBAL Assessment were interrogated.

Results

The confirmatory factor model showed good fit, indicating that each of the model factors are related but distinct and all items load significantly onto their factors. The WBAL Assessment demonstrated high internal consistency (Cronbach's α = 0.95) and internal validity across well-being factors and Feelings (r = 0.96) and Experiences (r = 0.94) domains. The WBAL Assessment demonstrated strong convergent validity in comparison to PERMA+ (r = 0.80) and WBA-24 (r = 0.75), indicating that the WBAL Assessment measures a similar overall concept of well-being and flourishing. Discriminant validity of WBAL factors was demonstrated for an average of 14.3 of 17 comparator domains. The main differences between instruments are WBAL's assessment of positive Experiences, the comparator instruments' inclusion of feelings with negative valence, and WBA-24's inclusion of financial stability.

Discussion

The WBAL Assessment is a reliable and valid instrument to comprehensively measure positive aspects of well-being that evaluates multiple modifiable contributors to individuals' well-being to guide design of personalized assessment and intervention programs to enhance positive well-being.

Effects of a Brief, Solution-Focused, Digital Intervention on Social Wellness Among College Students: A Pilot Study

PURPOSE

Current trends among college students include compromised mental health and wellness which have been exacerbated due to COVID-19. This pilot study examined the effectiveness of a brief, digital intervention focused on social wellness among college students on wellness-related outcomes including perceived wellness, life satisfaction, and happiness.

MATERIALS AND METHODS

A longitudinal, explanatory mixed-methods design was utilized. Quantitative data were collected from a total of 133 participants using questionnaires at baseline and one-week post-intervention. RM-ANOVA and post-hoc pairwise comparisons were employed to assess quantitative data. Qualitative data collection was obtained via semi-structured interviews at six weeks post-intervention and evaluated using Applied Thematic Analysis. A sub-sample (n = 23) from the participant pool (N = 133) completed the interviews.

RESULTS

Results indicated intervention effectiveness as participants experienced significant positive change in perceived wellness, the primary outcome variable. Significant relationships were detected between wellness outcomes and goal attainment (e.g. I am confident in my ability to complete my goals) items. Qualitative analysis revealed themes related to accessibility and convenience of the intervention, increased self-awareness, and increased intentionality of participants.

DISCUSSION

This study demonstrates the utility of a brief, digital intervention on wellness-related outcomes. Benefits were shown of a preventative, self-directed and solution-focused approach in enhancing wellness among college students.

CONCLUSION

From a social work perspective, employing a salutogenic approach to support college students' wellbeing aligns with the field's core values. Specifically, this social wellness-focused intervention encourages self-determination, dignity and worth of the person, and emphasizes the importance of human relationships.

Psychometric Properties of the Body-Mind-Spirit Wellness Behavior and Characteristic Inventory for the Greek Population

The Body-Mind-Spirit Wellness Behavior and Characteristic Inventory (BMS-WBCI) is a free-of-charge wellness tool with good psychometric properties, widely used mainly in studies assessing quality of life and healthy lifestyle habits. This certain tool is based on the Hettler's (1980) model and has been validated for use with students aged 18-36. The purpose of this study was to adapt the BMS-WBCI in the Greek language and at the same time to validate it for use in the general population. This study included 520 participants aged 16-75 (M = 39.86, SD = 10.5), who were recruited from the Greek population using the snowball procedure. The BMS-WBCI was adapted into Greek language, following a multiple forward-and-backward translation protocol. Confirmatory Factor Analysis (CFA) was used to validate the overall construct of the Greek BMS-WBCI. The final solution was a three-factor model with 38 items, after removing the items B1, B8, B9, M11, M24, and S43. This final model demonstrated an acceptable to good fit, presenting higher goodness-of-fit indices (CFI = 0.91, TLI = 0.90) and lower badness-of-fit indices (χ2/653 = 2.29, p < 0.001, RMSEA = 0.05, SRMR = 0.06). All items in the hypothesized model exhibited statistically significant standardized factor loadings (p < 0.001), with loadings consistently above 0.40. A very good internal consistency was found using the composite reliability measures (Body 0.86, Mind 0.95, Spirit 0.94). Further analysis indicated a good convergent validity (average variance extracted values: Body 50.5%, Mind 50.7%, Spirit 54.9%). The results indicated adequate discriminant validity, as all square roots of average variance extracted were higher than the correlation between construct items. In conclusion, this psychometric evaluation of the BMS-WBCI adds to the evidence supporting its use in the Greek language, not only in students, but also in the general population.

Building Consensus on Domains of Wellness Using Finnish and International Expert Panels: A Delphi-Method Study

PURPOSE

The paper investigates whether we can build consensus on wellness domains and create a more universal conceptual framework for wellness.

DESIGN

A modified ranking type of Delphi method.

PARTICIPANTS

Two separate panels consisting of 23 Finnish and 11 international experts.

METHODS

Panels were asked to rate the importance of 61 systematic review-based wellness domains and to eventually form a wellness model in both panels. The similarities between the resulting models were investigated and a new conceptual framework for wellness was created.

RESULTS

The Finnish model included 8 themes and 20 domains, and the international model 5 themes and eleven domains. Eight of the eleven domains were an exact match for the Finnish model (namely mental health, cognitive health, exercise, nutrition, community, life satisfaction, meaningfulness, work-life balance). There were also 2 similar domains that could be found in both models (namely self-care and lifestyle habits, social networks). A new conceptual framework for wellness was created based on these ten domains.

CONCLUSION

The lack of consensus on the wellness construct has made it difficult to find comparable measures that could assess and improve the level of wellness of individuals, organizations, and society. This study offers a conceptual framework that can be further validated and turned into a more universal measurement instrument.

Using online wellness assessment to screen for risk of lowered work ability, burnout, depression and anxiety in occupational health: A cross-sectional study

Objectives

An increasing prevalence of disability and sickness absences related to mental health highlights the need to find scalable measures to identify common occupational health challenges early on. This study (1) investigates how well current work ability measures capture psychosocial occupational health challenges, (2) examines how online wellness questionnaire data are linked to these challenges and (3) suggests a limited set of questions for screening employees.

Methods

A total 709 employees filled out a wellness survey, the Work Ability Index, the Bergen Burnout Indicator and screening questions for generalized anxiety disorder and depression. The survey question clusters and previously identified domains of wellness were used to examine the correlations between the domains and occupational health indicators. Linear models and stepwise Akaike information criterion model reduction were used to identify questions that most explained variation in each challenge. The strongest questions were combined into a set, and recursive partitioning was used to form a screening tool for occupational health.

Results

Despite over 80% of participants having good perceived work ability, we found a simultaneous anxiety risk in 22%, depression risk in 30%, some burnout symptoms in 7% and presenteeism in 36% of the participants. Correlations between several wellness domains and occupational health indicators were found. We identified eight questions that could be used to screen for a combined risk of lowered work ability, burnout, anxiety or depression.

Conclusions

Our results demonstrate current measures not being sufficient to capture employees' mental health and suggest a brief set of questions to identify employees at risk.

Mind, body, and spirit: a constructivist grounded theory study of wellness among middle-class Black women

Previous studies show that Black women in the United States experience disproportionately poorer health outcomes compared to women of other racial/ethnic groups. Recently the focus is on improving the health of Black women in the United States. However, there is little empirical evidence on what Black women need to improve their health to be well. The goal of this constructivist grounded theory was to increase the understanding of wellness among middle-class Black women (N = 30) in a large Midwestern city in the United States through an intersectional lens. The findings show that the connection and balance between mind, body, and spirit was the core experience of wellness among middle-class Black women. Mind, body, and spirit was described in three ways-(a) mentally managing, (b) physically caring for my body, and (c) connecting spiritually-with the women also noting the barriers and facilitators they endured to be well. Each of these categories highlight the tension middle-class Black women experience with trying to be well. Implications for future practice and research with middle-class Black women are discussed.

Chinese cross-cultural adaptation and validation of the Well-being Numerical Rating Scales

Introduction

Well-being is a multi-domain concept that involves measuring physical, psychological, social, and spiritual domains. However, there are currently few multi-domain and comprehensive well-being instruments available. In addition, measures that do exist customarily contain a vast number of items that may lead to boredom or fatigue in participants. The Well-being Numerical Rating Scales (WB-NRSs) offer a concise, multi-domain well-being scale. This study aimed to perform the translation, adaptation, and validation of the Chinese version of WB-NRSs (WBNRSs-CV).

Methods

A total of 639 clinical participants and 542 community participants completed the WB-NRSs-CV, the Single-item Self-report Subjective Well-being Scale (SISRSWBS), the World Health Organization Five-item Well-Being Index (WHO-5), the 10-item Perceived Stress Scale (PSS-10), and the Kessler Psychological Distress Scale (K10).

Results

High internal consistency and test-retest reliability were obtained for both samples. Additionally, WB-NRSs-CV was positively associated with SISRSWBS and WHO-5 and negatively associated with PSS-10 and K10. In the item response theory analysis, the model fit was adequate with the discrimination parameters ranging from 2.73 to 3.56. The diffculty parameters ranged from -3.40 to 1.71 and were evenly spaced along the trait, attesting to the appropriateness of the response categories. The invariance tests demonstrated that there was no difference in WB-NRSs-CV across groups by gender or age.

Discussion

The WB-NRSs-CV was translated appropriately and cross-culturally adapted in China. It can be used as a rapid and relevant instrument to assess well-being in both clinical and non-clinical settings, with its utility for well-being measurement and management among the Chinese people.

The mediator role of well-being in the effect of COVID-19 anxiety on occupational commitment: research in the aviation sector

The coronavirus (COVID-19) pandemic, which emerged in China in December 2019, has severely affected many industries across the world and created substantial psychological, social and economic impact on individuals. With the coronavirus outbreak labelled as a pandemic by the World Health Organization, the first measures have been taken for the aviation industry. The crisis environment created by the pandemic had a negative impact on aviation personnel. The main purpose of this research is to investigate the mediator role of employee well-being in the effect of COVID-19 anxiety on occupational commitment. The data were collected through a survey of cabin and cockpit staff (n = 3862). After the analyses, it was found that the effect of COVID-19 anxiety on well-being, and occupational affective and normative commitment was significant. Moreover, it is among the findings that well-being has a partial mediator role in the effect of COVID-19 anxiety on occupational affective and normative commitment.

A Study on Market Segmentation According to Wellness Tourism Motivation and Differences in Behavior between the Groups-Focusing on Satisfaction, Behavioral Intention, and Flow

The purpose of this study was to derive the visit motivations of wellness tourists and to derive strategies for the wellness tourism market through market segmentation based on visit motivations. First, this study derived seven motivators through a literature review with a discussion of experts: relaxation/healing/escape from everyday life, health improvement, novelty, luxury and prestige, self-examination/education, nature-friendly motivation, and social relations improvement. Then, in order to derive differentiated characteristics by motivation according to market segmentation, a difference analysis was conducted with the satisfaction, behavioral intention, and flow of wellness tourism participants. Data collection was carried out with the users of Chungcheongbuk-do wellness tourism products, and was supported by the Ministry of Culture, Sports, and Tourism (South Korea) from 2 September to 4 December 2021. Through the analysis in this study, it was first found that the wellness tourism motivations of wellness tourists were divided into a total of six factors (relaxation/healing/health improvement, novelty, luxury and prestige, self-examination/education, nature-friendly motivations, and social relation improvement). Then, as for market segmentation according to the visit motivations of wellness tourists, it was found that the markets were divided into "novelty-seeking type, comprehensive motivation-seeking type, neutral wellness-seeking type, and exploratory wellness-seeking type." Finally, it was determined that there were significant differences in satisfaction, behavioral intention, and flow among those types of wellness tourist groups, and the average levels of satisfaction, behavioral intention, and flow were commonly lower in the neutral wellness-seeking type than in the comprehensive motivation-seeking type and the exploratory wellness-seeking type. This study derived the necessity to conceive differentiated strategies for the wellness tourism motivation group with the development of a wellness tourism motivation scale and a market segmentation study, and provided practical implications according to the characteristics of individual groups.

Rethinking mental health wellness among adolescents living with HIV in the African context: An integrative review of mental wellness components

Objective

Adolescents living with HIV (ALHIV) are considered to be at heightened risk for developing mental health problems in comparison to their peers due to the burden of living with a stigmatized condition and managing a chronic condition. Poorer mental health outcomes among ALHIV are associated with lower rates of adherence to anti-retroviral therapy (ART). It is necessary to improve mental wellness among ALHIV as this acts as a buffer against developing mental health problems which, if left untreated can evolve into mental health disorders. Research on mental wellness concepts among ALHIV is underdeveloped which is associated with a lack of appropriate measures of mental wellness. We conducted an integrative review to conceptualize mental wellness and consider the critical components for measuring mental wellness in ALHIV.

Method

An integrative review of published literature focusing on mental wellness of ALHIV in the African context was conducted. The process was guided by the PRISMA operational steps. As part of our problem identification phase, we drew on findings from a previous systematic review of mental wellness instruments and a qualitative photovoice study on exploring the experiences of ALHIV, to develop an initial framework of 13 mental wellness concepts and behaviors which informed the search strategy.

Results

The review included 17 articles from which we identified six mental wellness concepts: Connectedness, Sense of Coherence (SOC), Self-esteem, Self-acceptance, Hope for the Future and Spirituality as well as six behaviors facilitating mental wellness: Coping, Resilience, Purpose in Life (goals), Self-efficacy, Adherence Self-efficacy, and Leisure Activities. All of these concepts and behaviors have been noted in our previous research (systematic review and qualitative work), with the exception of adherence self-efficacy. Based on the findings from this review and our previous work, we adapted the Salutogenic Model of Health developed by Antonovsky in 1987, to propose a Salutogenic Model of Mental Wellness (SMoMW) for ALHIV in the African context. This SMoMW may be used to develop an age and culturally appropriate measure of mental wellness for ALHIV.

Conclusion

The findings from this review used to conceptualize mental wellness among ALHIV which can be used to develop a measurement of mental wellness.

Prediction of Wellness Condition for Community-Dwelling Elderly via ECG Signals Data-Based Feature Construction and Modeling

The accelerated growth of elderly populations in many countries and regions worldwide is creating a major burden to the healthcare system. Intelligent approaches for continuous health monitoring have the potential to promote the transition to more proactive and affordable healthcare. Electrocardiograms (ECGs), collected from portable devices, with noninvasive and cost-effective merits, have been widely used to monitor various health conditions. However, the dynamic and heterogeneous pattern of ECG signals makes relevant feature construction and predictive model development a challenging task. In this study, we aim to develop an integrated approach for one-day-forward wellness prediction in the community-dwelling elderly using single-lead short ECG signal data via multiple-features construction and predictive model implementation. Vital signs data from the elderly were collected via station-based equipment on a daily basis. After data preprocessing, a set of features were constructed from ECG signals based on the integration of various models, including time and frequency domain analysis, a wavelet transform-based model, ensemble empirical mode decomposition (EEMD), and the refined composite multiscale sample entropy (RCMSE) model. Then, a machine learning based predictive model was established to map the l-day lagged features to wellness condition. The results showed that the approach developed in this study achieved the best performance for wellness prediction in the community-dwelling elderly. In practice, the proposed approach could be useful in the timely identification of elderly people who might have health risks, and could facilitating decision-making to take appropriate interventions.

'Touch for Health' based kinesiology interventions: An innovative qualitative research exploring clients' perspectives

BACKGROUND AND PURPOSE

Touch for health (TFH) based kinesiology is a complementary therapy with foundations in a natural health training developed utilising techniques from chiropractic, osteopathy and acupressure therapies. Although popular, the impact of the therapy is poorly understood. The aim of this study was to understand outcomes of TFH-based kinesiology interventions that clients perceive as important in their lives.

MATERIALS AND METHODS

A qualitative phenomenological approach was chosen to capture rich descriptive data. Thirteen individuals were recruited from TFH-based kinesiology practices. Focus groups included semi-structured questions, photo-elicitation and a wellness word activity to prompt discussion on impacts of interventions. Audio-recordings were transcribed, coded and grouped to develop themes. Comparisons were made and linked with the wellness model, theory of planned behaviour and mindfulness-based interventions.

RESULTS

Three interrelated themes emerged: impact on awareness, experience of effects and impact on action. TFH-based kinesiology was perceived to enhance self-awareness and feelings of wellbeing, promote self-care and support new actions to manage stress and complement conventional healthcare. The use of a mind-body approach with feedback from muscle testing and less need for dialogue were valued. Photo-elicitation generated rich narratives recounting experiences after interventions. Impacts aligned with the wellness model and resembled outcomes of mindfulness-based interventions.

CONCLUSION

This study provides an insight into experiences and impacts of TFH-based kinesiology. Interventions were seen to facilitate self-awareness, experiences of wellbeing and promote self-care. Findings contribute towards a knowledge-base to foster dialogue and inform TFH-based kinesiologists, health professionals, consumers and research of TFH-based kinesiology and comparative therapies.

Influence of Evidence-Based Design Strategies on Nurse Wellness

OBJECTIVES

The purpose of this study was to understand how specific evidence-based design strategies are related to aspects of nurse wellness.

BACKGROUND

Addressing burnout among the healthcare workforce is a system-level imperative. Nurses face continuous and dynamic physical and emotional demands in their role. Greater insight into the role of the physical environment can support efforts to promote nurse wellness.

METHODS

This exploratory qualitative study was conducted at new Parkland Hospital in Dallas, TX. We conducted five focus groups with nursing staff in July 2018. These sessions covered five topics related to nursing work in the facility which had been redesigned nearly 3 years earlier: (1) professional and social communication, (2) workflow and efficiency, (3) nurses' tasks and documentation, (4) ability to care for patients, and (5) nurses' overall health. We conducted a thematic analysis and first identified different aspects of wellness discussed by participants. Then, we examined how nurses related different design elements to different aspects of their wellness.

RESULTS

Participants included 63 nurses and nurse managers. They related environmental factors including facility size, break rooms, and decentralized workstations to social, emotional/spiritual, physical, intellectual, and occupational aspects of wellness.

CONCLUSIONS

It is critical to inform and integrate nurses at all levels into planning, design, and activation of new healthcare environments in order to ensure the well-being of nurses and, therefore, their ability to effectively support patients.

Framing well-being in a college campus setting

This investigatory study sought to explore the range and variation of well-being initiatives on a select cross-section of college campuses across the United States and in Canada. This whitepaper seeks to highlight innovative practices that may inspire institutions to consider new ways of promoting well-being for both students and employees. In this whitepaper, we report findings from 10 participating higher education institutions across three major categories: student-serving programs, employee-serving programs, and hybrid programs. The qualitative data collected from key stakeholder interviews and focus groups were analyzed for trends between and across institutions. Importantly, the results of this study are intended to be hypothesis-generating as opposed to hypothesis-testing. In an effort to describe the state of the field with respect to both common and innovative practices the findings have generated additional questions for further research. Several themes emerged from this study: (1) Campuses have not adopted a universally-accepted definition of well-being; (2) While many institutions are using iterations of the wellness wheel and its various dimensions (e.g. physical, emotional, intellectual, social, spiritual, financial) to guide their efforts, there is not a dominant model for structuring or measuring well-being initiatives on campus; (3) There appears to be a systematic shift from use of the term "wellness" to "well-being"; (4) While many institutions are still utilizing traditional health education practices, there appears to be a movement toward more systemic, environmental approaches to well- being, including structural, organizational, and financial strategies, in addition to a range of policy initiatives; (5) There is a range of engagement in well-being initiatives, with significant variance based on institutional philosophy; and (6) Many institutions are designing well-being initiatives that address health disparities-particularly among underrepresented or marginalized populations.

The Spiritual Wellness of an Intellectual, Novelist, Journalist and Politician: The Meaningful Life of Sol Plaatje

The study investigates Sol Plaatje's (1876-1932) spiritual wellness across his lifespan. He was purposively sampled due to his impact upon South African society. As an intellectual, novelist, journalist, and politician, Plaatje was also a founder member of the South African Native National Congress, which later became the African National Congress. His life history reflected a significant degree of spiritual wellness, which was uncovered through the systematic analysis of publicly available life-history materials, including primary and secondary sources. The Wheel of Wellness (WoW) model by Sweeney and Witmer was applied to interpret the biographical evidence of spirituality and meaning in his life. Spirituality, as the central life task of the WoW, and regarded as the most influential domain of a healthy individual, incorporates religious beliefs and other individualised aspects of meaning-making. Findings indicate that spirituality characterised Plaatje's childhood years and continued to play a role throughout his adult years. His sense of meaning and purpose was personified in the promotion and preservation of human rights and dignity, which embraced inter-racial respect, compassion, and service to others.

Student well-being during dedicated preparation for USMLE Step 1 and COMLEX Level 1 exams

BACKGROUND

Nearly all U.S. medical students engage in a 4-8 week period of intense preparation for their first-level licensure exams, termed a "dedicated preparation period" (DPP). It is widely assumed that student well-being is harmed during DPPs, but evidence is limited. This study characterized students' physical, intellectual, emotional, and social well-being during DPPs.

METHODS

This was a cross-sectional survey sent electronically to all second-year students at four U.S. medical schools after each school's respective DPP for USMLE Step 1 or COMLEX Level 1 in 2019. Survey items assessed DPP characteristics, cost of resources, and perceived financial strain as predictors for 18 outcomes measured by items with Likert-type response options. Open-ended responses on DPPs' influence underwent thematic analysis.

RESULTS

A total of 314/750 (42%) students completed surveys. DPPs lasted a median of 7 weeks (IQR 6-8 weeks), and students spent 70 h/week (IQR 56-80 h/week) studying. A total of 62 (20%) reported experiencing a significant life event that impacted their ability to study during their DPPs. Most reported 2 outcomes improved: medical knowledge base (95%) and confidence in ability to care for patients (56%). Most reported 9 outcomes worsened, including overall quality of life (72%), feeling burned out (77%), and personal anxiety (81%). A total of 25% reported paying for preparation materials strained their finances. Greater perceived financial strain was associated with worsening 11 outcomes, with reported amount spent associated with worsening 2 outcomes. Themes from student descriptions of how DPPs for first-level exams influenced them included (1) opportunity for synthesis of medical knowledge, (2) exercise of endurance and self-discipline required for professional practice, (3) dissonance among exam preparation resource content, formal curriculum, and professional values, (4) isolation, deprivation, and anguish from competing for the highest possible score, and (5) effects on well-being after DPPs.

CONCLUSIONS

DPPs are currently experienced by many students as a period of personal and social deprivation, which may be worsened by perceived financial stress more than the amount of money they spend on preparation materials. DPPs should be considered as a target for reform as medical educators attempt to prevent student suffering and enhance their well-being.

Considerations regarding the relationship between Fitness, Wellness and Healthy Lifestyle

Introduction. Currently, the crises triggered by the pandemic, in the fields of health, freedom of movement, economic, with impact in the social and cultural spheres, bring back today the practical applicability of the concepts of fitness and wellness. Material and method. In our study we will refer to the effects of the pandemic on health (everyone's well-being), to see how they accentuated the negative effects of the risks that specialists linked to sedentary lifestyle; increased stress; static anti-physiological positions for prolonged periods of time, which result in cardiovascular disease, metabolic syndrome and even cancer, to which is added an irrational diet. We will also refer to the relationship between the quality of life of people and the need to find the most effective ways to combat the negative effects of risk factors, by overcoming the obstacles posed by the financial situation and cultural patterns both in terms of lifestyle, as well as the eating behavior of people from different backgrounds. Results and discussions. We are of the opinion that specialists must go in their approaches, from the cultural understanding of man, to find ways to individualize the means of intervention so as to achieve the proposed objectives. The framework could be, for children and adolescents - the reorganization of school physical education, and for young people and adults - leisure activities, in which the emphasis could be falls on the concepts of Fitness and Wellness, with a beneficial effect on quality of life and personal satisfaction. Conclusion In this context, we believe that it is necessary to reconsider the need to make the population aware of the formation of a healthy lifestyle. The means could be physical fitness, wellness, rational nutrition and recovery according to the effort made, their benefits can have a major impact on health and prolong life expectancy. Keywords: Fitness, Wellness, Health, Physical education, cultural perspectives,

Expanding the purview of wellness indicators: validating a new measure that includes attitudes, behaviors, and perspectives

Objective

The present study validated the DeltaQuest Wellness Measure (DQ Wellness), a new 15-item measure of wellness that spans relevant attitudes, behaviors, and perspectives.

Design

This cross-sectional web-based study recruited chronically-ill patients and/or caregivers (n = 3,961) and a nationally representative comparison group (n = 855).

Main Outcome Measures

The DQ Wellness assesses: a way of being in the world that involves seeing and embracing the good and expressing kindness toward others; engagement in one's activities and self-care; downplaying negative thoughts that reduce one's energy; and an ability to feel joy. Six widely used measures of physical and mental health, cognition, and psychological well-being enabled construct-validity comparisons. Item-response theory (IRT) methods evaluated reliability, factor structure, and differential item functioning (DIF) by gender.

Results

The DQ Wellness showed strong cross-sectional reliability (marginal reliability = 0.89) and fit a bifactor model (RMSEA = 0.063, CFI = 0.982, TLI = 0.983). The DQ Wellness general score demonstrated construct validity, convergent and divergent validity, unique variance, and known-groups validity, and minimal gender DIF. The study is limited to addressing cross-sectional reliability and validity, and response rates are not known due to the recruitment source.

Conclusion

The DQ Wellness is a relatively brief measure, taps novel content, and could be useful for observational or interventional studies.

"Everything else is going to be ok if your spiritual wellness is well". A qualitative exploration of wellness amongst secondary school students in Fiji

PURPOSE

Adolescent wellness over the years has been a major public health concern. The adolescent period is stated to be a critical phase as developments occur in all areas of the individual. This study aims to explore secondary school students' perceptions on knowledge of wellness, influences of wellness, prioritization of wellness dimensions and ideal adolescent wellness programmes in Fiji.

METHOD

This study qualitatively investigates adolescents in four purposively selected schools in Suva, Fiji. 31 students who enrolled into years 11 to 13 in the selected schools were interviewed in-depthly using a semi-structured, open-ended questionnaire. Data was transcribed and classified into categories, sub-themes and major themes.

RESULTS

Participants' responses indicated wellness perceived as multidimensional with no regard to dimensional balance. Family, peers and school support, social media, nutrition and physical activities are factors perceived to influence wellness. The availability of school counsellors, facilitation of effective school health programmes, and incorporation of wellness into the school curriculum were perceived as ideal ways to increase adolescent wellness.

CONCLUSIONS

This study provides important research findings of adolescent wellness for Fiji's health sector, its policymakers and programme developers. Further studies are needed to understand the broad concept of wellness and its several dimensions.

Interventions to improve the well-being of medical learners in Canada: a scoping review

BACKGROUND

Medical education affects learner well-being. We explored the breadth and depth of interventions to improve the well-being of medical learners in Canada.

METHODS

We searched MEDLINE, EMBASE, CINAHL and PsycINFO from inception to July 11, 2020, using the Arksey-O'Malley, 5-stage, scoping review method. We included interventions to improve well-being across 5 wellness domains (i.e., social, mental, physical, intellectual, occupational) for medical learners in Canada, grouped as undergraduate or graduate nonmedical (i.e., health sciences) students, undergraduate medical students or postgraduate medical students (i.e., residents). We categorized interventions as targeting the individual (learner), program (i.e., in which learners are enrolled) or system (i.e., higher education or health care) levels.

RESULTS

Of 1753 studies identified, we included 65 interventions that aimed to improve well-being in 10 202 medical learners, published from 1972 through 2020; 52 (80%) were uncontrolled trials. The median year for intervention implementation was 2010 (range 1971-2018) and the median length was 3 months (range 1 h-48 mo). Most (n = 34, 52%) interventions were implemented with undergraduate medical students. Two interventions included only undergraduate, nonmedical students; none included graduate nonmedical students. Most studies (n = 51, 78%) targeted intellectual well-being, followed by occupational (n = 32, 49%) and social (n = 17, 26%) well-being. Among 19 interventions implemented for individuals, 14 (74%) were for medical students; of the 27 program-level interventions, 17 (63%) were for resident physicians. Most (n = 58, 89%) interventions reported positive well-being outcomes.

INTERPRETATION

Many Canadian medical schools address intellectual, occupational and social well-being by targeting interventions at medical learners. Important emphasis on the mental and physical well-being of medical learners in Canada warrants further exploration.

Workplace Health Promotion, Employee Wellbeing and Loyalty during Covid-19 Pandemic—Large Scale Empirical Evidence from Hungary

Corporate social responsibility (CSR) has become an innovative strategic management tool of socially and environmentally conscious business organizations in the 21st century. Although external CSR activities are better researched, firms’ internal CSR activities such as workplace health promotion and its impact on employee wellbeing are less understood, especially during a pandemic where job security is relatively lower in many sectors of employment. Additionally, wellbeing and good health have been recognized as important targets to achieve as part of the United Nation’s Sustainable Development Goal 3. Therefore, this study investigates the relationship between health-related work benefits and employee wellbeing, satisfaction and loyalty to their workplace. Large scale survey research was performed with responses from 537 employees in Hungary and 16 hypotheses were tested. Data analysis and path modelling using PLS-SEM (Partial Least Squares Structural Equation Modelling) reveal two-layers of factors that impact employee wellbeing, satisfaction and loyalty. We term this as ‘internal locus of control’ and ‘external locus of control’ variables. Internal locus of control variables such as mental and emotional health leads to wellbeing at the workplace but do not directly impact employee satisfaction and loyalty. In contrast, external locus of control factors such as healthcare support leads to wellbeing, satisfaction and loyalty. Employer commitment to healthcare support system is found pertinent especially during the pandemic. We discover wellbeing as a unique standalone construct in this study, which is vital as is it formed by mental and emotional wellbeing of employees, albeit not a determinant of employee workplace satisfaction and loyalty. We theorize workers’ self-reliance and preservation as possible explanations to the disassociation between employee wellbeing and loyalty to workplace during times of crisis and the pandemic.

Why impaired wellness may be inevitable in medicine, and why that may not be a bad thing

CONTEXT

A wellness crisis exists among physicians and medical trainees. High rates of burnout, depression, stress and other states of impaired wellness have driven a sense of urgency to create solutions, and the medical education community has mobilised impressively. However, we argue-and data suggest-that this rush to find solutions has outpaced our efforts to more fully understand the nature of impaired wellness in medicine. This, we believe, has led to the implementation of solutions informed by limited understanding of the problems we intend to solve.

METHODS

In this paper, we explore three contributors to this situation: (i) shaky definitions and conceptualisations of wellness, (ii) the predominance of deductive, quantitative research informing our understanding and current solutions, and (iii) the reliance on a 'disease-focused' approach to addressing impaired wellness in physicians and trainees. We discuss how these contributors have led to the current state of the science of wellness in medicine: one characterised by an expanding array of solutions built upon narrow conceptualisations of wellness and how it can be impaired.

DISCUSSION

Moving beyond the current state of the science on wellness in medicine will require three critical developments: (i) consistent use of clear definitions of wellness; (ii) expanding our methodologies to include those utilising direct interaction with participants; and (iii) moving beyond solutions informed by a disease-model approach. We propose a different way of thinking about wellness: one based on what we view as an inherent-and potentially unavoidable-risk of experiencing impairment during a career in medicine. We argue that efforts to extinguish and eliminate all states of impaired wellness may also eliminate opportunities to develop constructive coping mechanisms and future resilience, and that wellness may best be conceptualised as healthy and authentic engagement with the inevitable adversity of a career in medicine.

Holistic wellness in the life of Angela Merkel: a call to revise the wheel of wellness in the light of new positive psychology movements and socio-cultural changes

Holistic wellness theories conceptualise wellness as a multidimensional and synergistic construct. The term wellness refers to a way of life oriented towards optimal health and wellbeing in which body, mind, and spirit are integrated by the individual to live life fully within the human and natural community. The proposed Wheel of Wellness Model incorporate five life tasks that are influenced by seven life forces that are, in turn, influenced by global events. In this study, the model is employed to explore the life of Angela Merkel from a psychobiographical and holistic wellness perspective. Merkel was purposively selected as an extraordinary leader who demonstrated exceptional coping abilities and wellness. Findings show that Merkel's wellness is particularly strong in terms of spirituality and self-direction. Suggestions are proposed how to expand the WoW in the context of latest positive psychology developments and with regard to socio-cultural changes within contemporary societies.

A pilot study exploring the relationship between wellness and physical fitness: an examination into autonomic health

Objective: To explore the relationship between physical fitness and wellness in order to determine if perceptions of wellness can be predicted by physical fitness level.Participants: Sixty-seven college students (41 females; M = 20.86 years, SD = 4.23 years) were recruited from a large southeastern university during March-May 2018.Methods: Baseline measures for skin conductance and heart rate variability were obtained. Participants completed a wellness questionnaire and a series of tests (body composition, cardiorespiratory fitness, flexibility, and muscular fitness) designed to determine physical fitness levels. Correlation and regression analyses were run to explore relationships between physical fitness and wellness measures.Results: Muscular fitness and composite physical fitness significantly predicted perceived wellness. Heart rate variability was significantly related to physical fitness components.Conclusion: College students endorse muscular fitness as representative of health status; suggesting that by remaining physically active, in particular through muscular fitness, college student quality of life and cardiovascular health can be improved.

The effectiveness of emotional wellness programs on mental health outcomes for adults with multiple sclerosis: a systematic review and meta-analysis

BACKGROUND

People with multiple sclerosis (MS) have a greater prevalence of depression and anxiety than the general population. Emotional wellness programs (any psychological or psychosocial interventions that focus on awareness, acceptance, managing, or challenging thoughts and feelings) could be important for people with MS. However, there have been no reviews on the effectiveness of emotional wellness programs for people with MS. The objective of this review was to determine the effectiveness of emotional wellness programs on mental health outcomes for adults with MS.

INCLUSION CRITERIA

Randomised controlled trials (RCTs) and quasi-experimental trials evaluating emotional wellness programs for adults with any form of MS were included. Mental health outcomes included were depression, anxiety, quality of life, and stress. The comparator groups were waitlist controls, usual care, or another intervention.

METHODS

This review was registered with PROSPERO (registration number CRD42019131082) and conducted in accordance with PRISMA guidelines. CINAHL, Cochrane, MEDLINE, PsycInfo, Web of Science, ProQuest Dissertations and Theses, Cochrane register of Controlled Trials, and Google Scholar were searched for English- language publications. Titles and abstracts were initially screened, followed by a screen of full text articles. Studies were critically appraised for methodological quality using the JBI standardised critical appraisal checklists. Data were extracted on intervention details, study outcome measures, behaviour change techniques, and results. Random effects meta-analyses were performed for outcomes assessed in at least five studies, with results reported as the standardised mean difference (SMD).

RESULTS

This review comprised 25 RCTs and four quasi-experimental studies (n participants=2323); 21 were included in meta-analyses. Meta-analyses produced statistically significant results favouring the interventions (SMD (95% CI) for depression -0.55 (-0.87, -0.24); anxiety -0.42 (-0.70, -0.14); quality of life 0.28 (0.14, 0.43); and stress -1.00 (-1.58, -0.43)). The most commonly used behaviour change techniques were behaviour practice/rehearsal, social comparison, and social support.

CONCLUSIONS

This review provides evidence to support the effectiveness of emotional wellness programs for improving mental health outcomes in adults with MS. However, these findings should be interpreted with caution given the high degree of heterogeneity between the studies, and potential for biases in analysis due to missing data and/or incomplete reporting.

The Potential Influence of Organic Food Consumption and Intention-Behavior Gap on Consumers' Subjective Wellbeing

This paper applied a self-administered survey to investigate the impact of organic food behavior and the intention-behavior gap in organic food consumption (OIBG) on consumers’ subjective wellbeing including physical, emotional, social and intellectual dimensions. The survey was carried out with 385 consumers. Furthermore, the study conducted a food test to explore the different impacts of organic and conventional food samples on the mental and physical conditions of consumers’ wellbeing applying a psychological questionnaire. The food test took place in a sensory lab with a panel of 63 untrained German consumers. The research findings demonstrated a positive impact of the organic food consumption on consumers’ subjective wellbeing, while no negative impact of OIBG has been perceived. Moreover, during the food test, consumers distinguished no differences between the impact of organic and conventional stimuli on their mental and physical status. Understanding how consumers perceive the impact of organic food consumption on their wellbeing is one important aspect. However, in the interest of narrowing the OIBG, it is more important to understand how consumers perceive the impact of this gap on their daily-life wellbeing.

Wellness Assessment of Alzheimer's Patients in an Instrumented Health-Care Facility

Wellness assessment refers to the evaluation of physical, mental, and social well-being. This work explores the possibility of applying technological tools to assist clinicians and professionals to improve the quality of life of people through continuous monitoring of their wellness. The contribution of this paper is manifold: a coarse-grained localization system is responsible for monitoring and collecting data related to patients, while a novel wellness assessment methodology is proposed to extract quantitative indicators related to the well-being of patients from the collected data. The proposed system has been installed at "Il Paese Ritrovato", an innovative health-care facility for Alzheimer's in Monza, Italy; first satisfactory results have been obtained, and the dataset shows great potential for several applications.

The Effects of a Mobile Wellness Intervention with Fitbit Use and Goal Setting for Workers

Background and Introduction: There is strong evidence that worksite wellness programs can significantly improve the health profile of participating workers. To date, little is known about research on the effects of mobile wellness interventions in worksite settings. Furthermore, no studies have been conducted to evaluate mobile wellness interventions with activity trackers and tailoring strategies for physically inactive workers in manufacturing companies. This study aimed to examine the effects of a mobile wellness intervention with Fitbit and goal setting using brief counseling and text messaging among workers. Materials and Methods: A total of 79 (n = 79) workers from large manufacturing companies were allocated into an experimental group (n = 41) and a control group (n = 38). All participants were asked to wear an activity tracker (Fitbit Charger HR) during all waking hours for 5 weekdays. Participants in the experimental group received Fitbit, daily motivational text messaging, and biweekly counseling with a specifically designed workbook for 12 weeks, whereas Fitbit was only provided to the control group. Results: At the 12-week measurement, there were significant differences between the experimental group and control group on wellness (p < 0.001), physical activity behavior (p < 0.001), daily walking steps (p < 0.001), and physical activity self-efficacy (p < 0.001). Discussion and Conclusions: Although Fitbit facilitates an individual's activities by providing information about daily steps, the tracker itself, without additional goal-setting techniques, may be insufficient to encourage behavior change. These findings indicate that the mobile wellness intervention with Fitbit and goal setting using brief counseling and tailored text messaging is more effective for physically inactive workers.

"Can One Put Faith and Work in the Same Sentence?" Faith Development and Vocation of a Female Leader in the Engineering Profession

Faith has been pointed out as a possible resource in strengthening individuals' health and well-being at work. The aim of this article is to gain in-depth knowledge of the faith development and vocation of a selected female leader in a male-dominated work context. The article contributes to research on faith development in women leaders, based on Fowler's faith development theory. This is a single case study grounded in a qualitative research design. In-depth qualitative data were gathered through observation and interviews over 18 months. Findings showed the development of faith across a women leader's life span and highlight that faith and vocation are important resources that provide strength, meaningfulness and a vision.

Solution-Focused Wellness: A Randomized Controlled Trial of College Students

Heightened stress levels and compromised well-being are common among college students. Current trends on college campuses include an increase in the number of students experiencing mental health issues and an increase in students seeking help, illustrating a need for evidence-based brief interventions that improve student wellness. This research study used a randomized controlled study design to examine the effects of a short-term (seven-week), solution-focused wellness intervention on perceived stress and wellness of college students. Repeated measures analysis of variance results demonstrated that the effect of group membership across time was significant for both perceived wellness and stress (p < .01). Effect sizes using partial eta2 statistics were large for both outcome variables. Findings indicate that a brief solution-focused wellness intervention can significantly improve perceptions of wellness and reduce stress among college students and is more effective than treatment as usual. Intervention replicability allows for dissemination across varied academic groups and locations, and potential generalization across populations.

Exploring Wellness Interventions in Progressive Multiple Sclerosis: an Evidence-Based Review

PURPOSE OF REVIEW

There has been recent interest in the role of lifestyle and wellness-based approaches in the treatment and management of multiple sclerosis (MS). These approaches may be particularly relevant for patients with progressive MS, considering limited therapeutic options currently available. The purpose of this review is to examine the role of wellness-based interventions including exercise training, emotional well-being therapies, and dietary modification in patients with progressive MS.

RECENT FINDINGS

We conducted a literature search on the efficacy of wellness-based interventions in patients with progressive MS published between 1985 and July 2017. The level of evidence for each trial was evaluated using the American Academy of Neurology criteria. Overall, 21 articles reporting on 16 wellness-based interventions were identified: ten trials involved exercise training, three involved emotional wellness therapies, two involved dietary modification, and one was a combined wellness intervention. There is level C evidence (possibly effective; one class II study) for the efficacy of aerobic exercise training on cardiorespiratory fitness in patients with progressive MS. There is level B evidence (probably effective; one class I study) for the efficacy of mindfulness training on psychological distress, depression, anxiety, pain, and quality of life in patients with progressive MS. There is inadequate evidence (level U) for efficacy of dietary modification (one class III study and one class IV study) and combined wellness interventions involving exercise training, meditation, and dietary modification (one class IV study). High-quality research is needed to provide evidence-based recommendations for wellness behaviors and lifestyle change in patients with progressive MS.

Mental Health Wellness and Biofield Therapies: An Integrative Review

Biofield therapies such as Healing Touch and Reiki increase relaxation, decrease anxiety and stress, and improve mood. Understanding the efficacy of these therapies in terms of mental health wellness is important for nurses interested in complementary and integrative care. The goal of the present integrative review was to investigate the state of knowledge regarding biofield therapies and the impact on anxiety, mood, and mental health wellness. Electronic databases were searched for articles available in English and published from 2014 to 2016. Biofield therapies show safety and promise in reducing anxiety, improving mood, and cultivating mental health and wellness.

Wellness among African-American and Caucasian students attending a predominantly White institution

The wellness movement is growing on college campuses; however, the examination of race is lacking. We examined aspects of physical and emotional well-being as a function of race in 197 college students at a predominantly White institution. Results revealed racial differences on diet, F(1, 196) = 7.537, p = 0.007 and resilient coping, F(1, 196) = 8.614, p = 0.004. Furthermore, regression analyses revealed that the association between stress and coping was moderated by race (F(1, 196) = 8.196, p = 0.005), demonstrating that Whites and Blacks experience and cope with stressors in differing ways. Findings of this study suggest that race is an influential factor of wellness and subsequent well-being in college students.

Evidence and Feasibility of Implementing an Integrated Wellness Program in Northeast Georgia

Evidence for the connection between physical and mental health is growing, as is interest in providing a holistic, mind-body approach to improving mental health and wellness. A needs assessment in northeast Georgia identified several regional health priorities, including mental health and substance abuse, access to care, and cardiovascular health. The study's purpose is threefold: to (1) review evidence for integrated mind-body wellness services, (2) explore the feasibility of implementing wellness services in a small mental health agency serving northeast Georgia, and (3) conduct a brief survey assessing interest in a wellness program. The literature search identified articles within the past 10 years with these key words: "yoga," "mental health," "wellness program," "complementary alternative medicine," "tai chi," "mindfulness," "meditation," and "nutrition." The survey was distributed to the agency's affiliates. The literature review identified strong evidence for an integrated mind-body wellness program that includes yoga, tai chi, mindfulness meditation, and nutrition education. Among 73 survey respondents, 86 percent indicated interest in wellness services, and 85 percent agreed that wellness services are important to mental health and well-being. Authors suggest a model to incorporate a holistic wellness program to complement mental health services and help facilitate physical and mental health.