Promoting Students' Health at University: Key Stakeholders, Cooperation, and Network Development

Status of the Health Promoting University (HPU) globally and its relevance for emerging African HPUs: an integrative review and bibliometric analysis

BACKGROUND

The Health Promoting Universities (HPU) concept is undertheorized, with no African university belonging to the International Network of Health Promoting Universities (IHPU).

AIM

The study aimed to investigate the status of the HPU concept globally to inform emerging HPUs, more specifically in Africa, regarding its implementation.

METHODS

An integrative literature review of studies conducted between 1 January 2013 and 5 November 2023 was conducted from online databases (PubMed, Scopus, Web of Science, Lilacs, CINAHL and Medline). A VOS bibliometric analysis viewer was used to extract and analyze further relevant information that could have been missed in the review.

RESULTS

From 1128 records, 22 (N = 22) articles including two reports met the inclusion criteria. The main findings were that: (1) the HPU network is growing as a global network though undertheorized and less reported on, (2) the implementation of the HPU depends on a plethora of underpinning philosophies such as salutogenic and whole systems approach, and diverse programs and initiatives, 3) the terms HPU and healthy universities are often used interchangeably but the whole systems approach appears to be consistent in many HPU interventions. However, five contextual challenges that emanated from this review were discussed, including the definition of the HPU concept, theories for the HPU concept, measurement of the HPU concept, coordination and methods for measuring the HPU concept status. These challenges present obstacles to measuring the status of the HPU concept beyond the number of affiliated universities and HPU initiatives.

CONCLUSION

Despite the challenges, the HPU concept is gaining momentum globally, as evidenced by the growing list of universities (HPU network) involved and the proliferation of interventions/initiatives targeting university students.

Network development in workplace health promotion - empirically based insights from a cross-company network promoting physical activity in Germany

BACKGROUND

In the field of health promotion, interorganisational networks are of growing relevance. However, systematic and target-oriented network management is of utmost importance for network development. The aim of this article is to report on the development of a cross-company network promoting physical activity, and to identify necessary activities and competencies for a systematic network management.

METHODS

The network was systematically planned and implemented in a German technology park comprising different companies. To assess and describe the development of the network, quantitative social network analysis was conducted. To answer the question on the activities and competencies for systematic network development semi-structured interviews with participating stakeholders, and a focus group discussion with health promotion experts were conducted. The interviews were analysed deductively and inductively with the structuring content analysis method and the focus group discussion was analysed deductively by summarising key aspects of the discussion.

RESULTS

Network metrics showed that the network became larger and denser during the planning phase, and stagnated during the implementation phase. As key facilitators for network development, participation of all stakeholders, a kick-off event, and the driving role of a network manager were identified. Necessary activities of the network manager were related to structural organisation, workplace health promotion offers, and cross-sectional tasks. The results suggested that not only professional and methodological competencies, but also social and self-competencies were required by the manager.

CONCLUSIONS

Our study provides initial guidance regarding the activities and required competencies of an interorganisational network manager. The results are of particular relevance for the context of workplace health promotion, since a network manager can be considered as a driving role for planning and implementing a cross-company network.

TRIAL REGISTRATION

The study is registered in the German Clinical Trials Register (DRKS00020956, 18/06/2020).

Analyzing mechanisms of interdisciplinary cooperation in promoting students' health at university

BACKGROUND

Interdisciplinary cooperation among university actors and resulting intersectoral synergies are considered cornerstones in the process of incorporating health promotion practices in everyday university life in order to break down barriers and provide better access to health promotion services. To date, no network of a health-promoting university has been examined regarding the processes underlying tie formation, network emergence, and maintenance.

OBJECTIVES AND METHODS

The goals of this study are to obtain insight into the mechanisms of cooperation between university actors in a health-promoting network and to identify the structural and attributive factors associated with establishing cooperation between actors in the observed network in order to better understand how to build and develop successful networks in the future. For this purpose, a social network analysis was carried out and exponential random graph models were estimated to test corresponding hypotheses.

RESULTS

The network at hand consists of 33 actors (e.g. University Sports Center, General Student Committee) and shows a flat, non-hierarchical structure. Data reveal that attributed competence predicts cooperation (0.32; p < 0.05). Significant homophily effects among student actors (1.31; p < 0.05) and among university actors (0.59; p < 0.05) were found. All structural predictors examined were significant (0.22-5.40; p < 0.05) and are therefore essential in determining the likelihood of cooperation between actors involved in the network.

CONCLUSION

The results of this study provide for a better understanding of the mechanisms of cooperation and can be used to further develop the network at hand (e.g. selection of key actors for information dissemination or integration of peripheral actors). In addition, the findings offer starting points for sustained network development at other universities (e.g. significance of network governance form or goal consensus). Knowing the factors that influence the network structure, here the conditions of cooperation, results in opportunities to encourage empowerment among actors. However, the analysis of the network undertaken does not directly bear on the success of the network.

The clusters of health-risk behaviours and mental wellbeing and their sociodemographic correlates: a study of 15,366 ASEAN university students

Background

This study investigated, through cluster analysis, the associations between behavioural characteristics, mental wellbeing, demographic characteristics, and health among university students in the Association of Southeast Asian Nations (ASEAN) University Network – Health Promotion Network (AUN-HPN) member universities.

Methods

Data were retrieved from a cross-sectional self-administered online survey among undergraduate students in seven ASEAN countries. A two-step cluster analysis was employed, with cluster labels based on the predominant characteristics identified within the clusters. The ‘healthy’ cluster was assigned as the reference group for comparisons using multinomial logistic regression analysis.

Results

The analytic sample size comprised 15,366 university students. Five clusters of student-types were identified: (i) ‘Healthy’ (n = 1957; 12.7%); (ii) ‘High sugary beverage consumption’ (n = 8482; 55.2%); (iii) ‘Poor mental wellbeing’ (n = 2009; 13.1%); (iv) ‘Smoker’ (n = 1364; 8.9%); and (v) ‘Alcohol drinker’ (n = 1554; 10.1%). Being female (OR 1.28, 95%CI 1.14, 1.45) and being physically inactive (OR 1.20, 95%CI 1.04, 1.39) increased the odds of belonging to the ‘High sugary beverage consumption’ cluster. Being female (OR 1.21, 95%CI 1.04, 1.41), non-membership in a sports club (OR 1.83, 95%CI 1.43, 2.34) were associated with ‘Poor mental wellbeing’. Obesity (OR 2.03, 95%CI 1.47, 2.80), inactively commuting to campus (OR 1.34, 95%CI 1.09, 1.66), and living in high-rise accommodation (OR 2.94, 95%CI 1.07, 8.07) were associated with membership in the ‘Smoker’ cluster. Students living in The Philippines, Singapore, Thailand, and Vietnam had a higher likelihood of being alcohol drinkers, compared with those who lived in Brunei.

Conclusions

ASEAN university students exhibited health-risk behaviours that typically clustered around a specific health behaviour and mental wellbeing. The results provided support for focusing interventions on one dominant health-risk behaviour, with associated health-risk behaviours within clusters being potential mediators for consideration.

Health Literacy Among University Students: A Systematic Review of Cross-Sectional Studies

OBJECTIVE

The aim of this systematic review was to provide an overview of cross-sectional studies that examined health literacy among university students and to identify possible determinants related to health literacy.

METHOD

The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Three databases (PubMed, Scopus, and Web of Science) were systematically searched for cross-sectional studies that examined health literacy among university students. Results of included studies were narratively summarized.

RESULTS

The systematic review includes twenty-one research studies. The majority of studies report health literacy scores among university students that are lower compared to reference samples. The health literacy of students is influenced by different variables (age, gender, number of semesters, course of studies/curriculum, parental education, and socioeconomic background).

DISCUSSION

Health literacy activities should target all students. Universities should make use of their resources and offer health literacy courses for students in which content is used from disciplines available at the university (e.g., medicine, health, or psychology). To increase effectiveness, health literacy courses should be adapted according to the different needs and characteristics of the student subgroups.