Abstract

Universities have been attempting to redefine wellness. The Center for Collegiate Mental Health reports growth in anxiety and depression in college students over the last four years (2017). Mental health is often associated with body weight (Luppino et al., 2010), which also has an upward trend. A recent nation-wide survey found that 38% of respondents self-reported being overweight or obese (American College Health Association, 2018). These statistics place an emphasis on the importance of campus recreational centers and counseling services. In the state of North Carolina there are 22 universities that have a “fitness” center, five are referred to as Wellness Centers.

This study sought to understand how students perceive wellness to be reflected within a campus wellness center. Eight variables (access to water, daylight, views of nature, and healthy food; opportunities for social interaction and physical activity; presence of indoor plant life and use of color and materials) contributing to wellness were identified in literature. These variables were the foundation for the study. The online questionnaire consisted of 26 items was administered to a convenience sample of 73 University of North Carolina Greensboro students.

Key findings indicate that the participants definition of wellness was holistic, encompassing aspects of both physical and mental health. However, how the students rated wellness within the campus wellness center focused more on physical fitness. The two attributes impacting wellness that were rated the most important to participants were access to drinking water and access to fitness activities and equipment both of which focus on physical fitness.

The results provide insight into how a wellness center is viewed and used by students. The research can be used as a basis for future studies as well as promoting a dialog within academia regarding their approach to the design and amenities of campus recreational centers.

Introduction

University campuses across the country have been attempting to redefine wellness. This is due in part to the understanding that wellness contributes to a sense of community, place, and purpose for students (Al-Amarri & Al-Khamees, 20015). College students are struggling with mental and physical health issues in larger numbers than ever before. In fact, the Center for Collegiate Mental Health (CCMH) reports growth in anxiety and depression in college students over the last four years (2017). Consequently, anxiety and depression are the top mental health issues students seek counseling for (CCMH, 2017). Mental health issues are often associated with body weight (Luppino et al, 2010), which also has a troubling trend upward.Thirty-nine percent of college students are considered overweight or obese (University of Minnesota, 2007). This coincides with a recent nation-wide survey that found that 23% of respondents self-reported being overweight and 15% being obese (American College Health Association, 2018). These statistics place an emphasis on the importance of campus recreational centers and counseling services.

Most universities assess recreational fitness amenities with a fee associated with tuition costs, giving students “free” access to the facilities (Danbert, Pivarkin, McNeil, & Washington, 2014). In the state of North Carolina there are 22 universities that have a “fitness”center on their campus. Of the 22 universities, 17 refer to them as a recreation or fitness centers. The remaining five are referred to as Wellness Centers, see Table 1.These Wellness Centers have all been constructed within the last five yearsshowing a trend among college campuses within the state to change the focus, at least in the name, to a more holistic concept - wellness. It is easy to change a building name or add descriptions of the building intent to a website. However, do students, the targeted users, view or use these spaces differently? Furthermore, what does wellness mean to university students?This study sought to understand how students perceive wellness to be reflected within a campus wellness center.

To begin to answer these questions we need to find out what attributes have been linked to wellness in the literature. In this research, wellness wasdefined by Hettler’s (1984) holistic wellness framework, which encompasses mental and physical aspects. Eight attributes that affect wellness and relate to the built environment were identified from a range of interdisciplinary literature. These eight attributes wereaccess to water, daylight, views of nature, and healthy food; opportunities for social interaction and physical activity; presence of indoor plant life and use of color and materials.

Healthy food such as fruits and vegetables have been linked to decreases in stress levels in Turkish students (Unusan, 2006), increased happiness, satisfaction, and subjective wellbeing in Australians age 15 years and older (Mukcic & Oswald, 2016), and a healthy lifestyle in students from Kuwait University(Al-Amarri & Al-Khamees, 2015). Increased water intake can decrease calorie intake and increase weight loss (McCaffrey, 2016). Furthermore, hydration is important for those involved in physical exercise such as high-intensity workouts and endurance activities (Popkin, D’Anci, & Rosenberg, 2010).

An abundance of research exists touting the physical and mental benefits of access to daylight. The research is largely focused on circadian rhythms (Abbott, Knutson, &Zee, 2017).There arealso many positive impacts on energy costs and lighting loads when daylight is effectively controlled within the built environment. Furthermore,research has shown that access to daylight can have a positive effect on academic performance (Baker, 2012). In conjunction with daylight, occupant’s access to exterior views is vital as it reinforces the relationship between people and the natural environment (Kellert et al., 2008). Research conducted on exterior views of nature have largely focused on healing times in hospitals and stress restoration in academic and work environments (Huisman, Morales, Van Hoof, & Kort, 2012; Largo-Wight, Chen, Dodd, & Weiler, 2011). The presence of plants can have both physical and mental benefits to occupants. The addition of greenery inside office environments has been shown to increase memory and task performance (Lipscomb & Rollings, 2017) and contribute to feelings of content and happiness (Dravigne, Waliczek, Lineberrger, & Zajicek, 2008). Plants can also enhance indoor air quality through the release of moisture and oxygen into the air and the reduction of dust (Lohr, 2010).

Opportunities for physical activities and social interaction are important for college students as both have been linked to health. Sense of community is positively correlated with social engagement among college students in the U.S., which affects social wellbeing (Cicognani, et al, 2008). Recreational areas on campus are one such location where social interactions often occur (Harrington, 2014). Recreational areas are also a common area for physical fitness. Plenty of research exists emphasizing the physical and mental benefits of exercise. However, new research also provides a link to higher GPAs among college students (Sanderson, DeRousie, & Guistwite, 2017).

Lastly, use of color and natural materialsareoften found in literature on biophilic design (Kellert et al., 2008). There are many theories discussing the influence of color on brain performance, however, a consensus has not been reached. Natural colors were shown to decrease negative moods in Japanese students (Saito & Tada, 2007). Use of natural materials as interior finishes were preferred by the general public and those in the design industry within Austria, Finland, Norway and Sweden (Bysheim, Nyrud, & Strobel, 2016).Wood when used as an interior finish had stress-reducing effects on college students in the U.S. (Fell, 2010).

The eight variables (access to water, daylight, views of nature, and healthy food; opportunities for social interaction and physical activity; presence of indoor plant life and use of color and materials) identified in interdisciplinary literature contributing to wellness, were the foundation for the study. The goal of this research was to 1) explore what wellness meant to students and 2) assess how wellness was represented within a university recreation center.

METHOD

The Leonard J Kaplan Center for Wellness located on the University of North Carolina Greensboro’s campus was selected as the site for this study because the building recently earned Leadership in Energy and Environmental Design (LEED) certification to the Gold level under New Construction rating system version 2009. The questionnaire was administered online with tablets over a three-day period at the Student Union on the University of North Carolina Greensboro’s campus. The exploratorystudy included a convenience sample of 73 interdisciplinary college students.

The web-based questionnaire consisted of 26 questions within two sections. The first section asked participants to identify aspects of the space that represented wellness using heat mapping questions. Heat mapping graphically depicts areas participants select, enhancing the visualization of the data, and allowing for identification of physical design components within the university setting. Eleven images were graphically modified using photo-editing software to incorporate attributes identified in the literature. For instance, in one image plants were digitally added. Participants were instructed to click on the area of the image they though most represented wellness. In addition, for each image, participants were asked to rate their perception of the level of wellness reflected in the image using a five-point Likert-type scale. The second section of the questionnaire addressed the amount of time spent within the building, the purpose for the visit, and the perceived importanceof the eight attributes identified in literature. These items used a five-point Likert-type scale ranging from extremely important to not at all important. Visual analysis was used to analyze heat mapping questions. Content analysis was used to analyze students’ definition of wellness. Descriptive statistics were used to summarize the findings.

FINDINGS

The majority of participants (80.6%) described aspects of the wellness in a holistic manner that dealt with health, such as “Being healthy, in a routine, through eating well, working out and being happy” or “Overall feeling related to emotional, physical, and spiritual well being.” The next most commonly referenced concept regarding wellness was specific to physical fitness (8.6%) as can be seen in the following example, “Staying fit and getting plenty of exercise.”

The distribution of frequency with which participants visited the Kaplan Center for Wellness was fairly evenly disbursed, see Figure 1. The majority (30%) of participants visited the Center weekly, while the next most common occurrence was never (21%). Of the 55 participants that had visited the Kaplan Center for Wellness, the most common reason was for the purpose of exercising (94.5%), see Figure 2. Six participants listed both socialization and exercise as their reason for visiting the center.

Figure 1. Frequency visiting the Center for Wellness

Figure 2. Reason for visiting the Center for Wellness

The results of the heat mapping questions and corresponding Likert-scale questions depicted how well participants felt wellness was represented within the image. The highest rated image received an average score of 4.2 (very well) on the five-point Likert scale, where 1 was “not well at all” and 5 was “extremely well.” This image of the pool contained examples of access to daylight and views of nature, opportunities for physical activity and social interaction, access to water, and use of color and natural materials, see Figure 3. The areas selected as most reflective of wellness were split between a group of people doing water aerobics and a person swimming laps. Both areas represent physical fitness, however, water aerobics also represents social interaction. The second highest rated image reflecting wellness received an average score of 4.1, reflecting “very well.” This image of the rock-climbing wall and track contained examples of access to daylight, multiple opportunities for physical activity, presence of indoor plants, access to water, and use of color and natural materials, see Figure 4.Again, the areas selected as most reflective of wellness represent physical fitness, people rock climbing or walking laps.

Figure 3.Highest Rated Image

Figure 4. Second Highest Rated Image

The lowest rated image reflecting wellness received an average score of 2.9, reflecting “moderately well.” This image of the entrance contained access to daylight, opportunities for social interactions, access to healthy food, use of colors and materials, and the presence of indoor plants, see Figure 5. The areas selected as most reflective of wellness were split between groups of people socializing and the “welcome” sign. The second lowest rated image reflecting wellness received an average score of 3.1, reflecting “moderately well.” This image of game area contained access to water, opportunities for social interaction, and use of colors and materials, see Figure 6. The areas selected as most reflective of wellness were split between the people playing pool and the water fountain.

Figure 5. Lowest Rated Image

Figure 6. Second Lowest Rated Image

Participants were asked to rate the importance of each of the eight attributes identified in literature within the context of the Kaplan Center for Wellness, see Figure 7. The most important attribute was access to drinking water, which received an average score of 4.8 (very well) on the five-point Likert scale, where 1 was “notat all important” and 5 was “extremely important.” The second most important attribute was access to fitness activities and equipment, which received an average score of 4.7, reflecting “extremely important.” The least important attribute was presence of indoor plants, which received an average score of 3.3, reflecting “moderately important.” The second least important attribute was views of nature, which received a score of 3.7, reflecting “very important.”

Figure. 7 Importance within the Center for Wellness

DISCUSSION +CONCLUSION

While the participants’ definition of wellness was holistic, encompassing aspects of both physical and mental health, how the students rated wellness within the Kaplan Center focused more onphysical fitness. The areas most commonly selected through heat mapping included people exercising whether in groups or alone.The lowest rated images both lacked imagery of fitness activities and equipment. The two attributes impacting wellness that were rated the most important to participants were access to drinking water and access to fitness activities and equipment both of which focus on physical fitness.While the name Kaplan Center for Wellness may imply a holistic approach to health, participants viewed the facility more in line with a traditional Recreation Center.

This may be a result of several factors. First of all, the Student Health Center on the University of North Carolina Greensboro’s campus is located in a separate facility from the Kaplan Center for Wellness. The two buildings are approximately a mile apart. The Student Health Center provides access to physicians, pharmacists, and counselors.In fact, all of student health services are offered within the Student Health Center. Therefore, the holistic focus of health (mental and physical) would be found at the Student Health Center instead of the Kaplan Center for Wellness.

Besides the fact that the focus of the Center is on physical fitness in the form of exercising, there is a lack of educational components that reflect the definition of wellness within the facility. Wellness centers should incorporate education within the facility whether it be classes, signage, or supportive imagery that focus on mental health or other components of physical health such as healthy eating. The Kaplan Center for Wellness held one class, Edible Wisdom Workshop, for three days in September. This was the only class that was offered that did not focus solely on exercising. The Facility holds several classes that students can enroll in, such as spin, body pump, Zumba, and power yoga. Power yoga may have a connection to the broader meaning of wellness depending on how it is taught. Schaben and Furness (2018) found that knowledge and perceptions of wellness increased in students that were enrolled in a general education course only when the educational component was required not voluntary. Therefore, educational components could be integrated into the courses that are offered on campus. The classes could also have activities that promote socialization, since that was listed as the second most common reason the students visited the Kaplan Center for Wellness.

In conclusion, if a wellness center wants to differentiate itself from a recreational center then the facility must take a holistic approach to its design and amenities. Fresh or healthy food should be accessible and easy to find within the build, including within the vending machines. Classes or activities that focus on the individual as whole should be incorporated into the schedule. Counseling services should be provided. Ample space to socialize and gather should be incorporated.

References

Abbott, S., Knutson, K., and Zee, P. (2018). Health implications of sleep and circadian rhythm research in 2017. The Lancet Neurology, 17(1), 17-18. Doi: https:doi.org/10.1016/S1474-4422(17)30410-6

Al-Amari, H. and Al-Khamees, N. (2015). The perception of college students about a healthy lifestyle and its effect on their health. Journal of Nutrition and food Sciences, 5(6) 437-440. doi: 10.4172/2155-9600.1000437

American College Health Association. (2018). American College Health Association-national college Health assessment II: Reference group executive summary fall 2017. Retrieved April 30, 2018, from http://www.acha-ncha.org/docs/NCHA-II_FALL_2017_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf

Baker, L. and Bernstein, H. (2012). The impact of school buildings on student health and performance. Retrieved October 20, 2018, from http://www.centerforgreenschools.org/impact-school-buildings-student-health-and-performance

Bysheim, K., Nyrud, A., and Strobel, K. (2016). Building materials and wellbeing in indoor environments. Retrieved May 28, 2018, from http://www.treteknisk.no/resources/filer/publikasjoner/rapporter/Rapport-88.pdf

Center for Collegiate Mental Health. (2017). Annual report. Retrieve January 5, 2018, from http://ccmh.psu.edu/publications/

Cicognani, E., Pirini, C., Keyes, C., Joshanloo, M, Rostami, R., and Nosratabadi, M. (2008). Social participation, sense of community and social wellbeing: A study on American, Italian and Iranian university students. Social Indicators Research, 89(1) 97-112. https://doi.org/10.1007/s11205-007-9222-3

Danbert, S., Pivarnik, J., McNeil, R. and Washington, I. (2014). Academic success and retention: The role of recreational sports fitness facilities. Recreational Sports Journal, 38, 14-22. http://dx.doi.org/10.1123/rsj.2013-0010

Dravigne, A, Waliczek, T., Lineberger, R., andZajicek, J. (2008). The effect of live plants and window views of green spaces on perceptions of job satisfaction. HortScience, 43(1), 183-187. http://hortsci.ashspublications.org/content/43/1/183.full.pdf+html

Fell, D. (2010) Wood in the human environment: Restorative properties of wood in the built indoor environment (Doctoral thesis). University of British Columbia. Retrieved on May 26, 2018 from https://open.library.ubc.ca/cIRcle/collections/ubctheses/24/items/1.0071305

Harrington, K. (2014) Community on campus: The role of physical space. (Doctoral dissertation) Georgia State University. Retrieved on May 26, 2018 from http://scholarworks.gsu.edu/epse_diss/92

Hettler, B. (1984). Wellness: Encouraging a lifetimes pursuit of excellence. Health Values, 8, 13-17

Huisman, E., Morales, E., Van Hoof, J., and Kort, H. 2012. Healing environment: A review of the impact of physical environmental factors on users. Building and Environment, 58, 70-80. https://doi.org/10.1016/j.buildenv.2012.06.016

Kellert, S., Heerwagen, J., and Mador, M. (2008). Biophilic Design: The theory, science, and practice of bringing buildings to life. Hoboken, NJ: Wiley.

Largo-Wight, E., Chen, W., Dodd, V., and Weiler, R. (2011). Healthy workplaces: The effect of nature contact at work on employee stress and health. Public Health Reports, 126(1), 124-130. Doi: 10.1177/00333549111260S116

Lipscomb, M., and Rollings, K. (2017). Influences of indoor plants on psychological well-being and memory task performance in a workplace setting. Perkins + Will Research Journal 9(2). 33-43. Retrieved August 03, 2018 from https://perkinswill.com/sites/default/files/ID_4_PWRJ_Vol0902_03_Outside_In.pdf

Lohr, V. (2010). What are the benefits of plants indoors and why do we respond positively to them? Acta Horticulturae 881(2). 675-682. Retrieved on August 03, 2018 from https://public.wsu.edu/~lohr/pub/2010LohrBenefitsPltsIndoors.pdf

Luppino, F. S., de Wit, L. M., Bouvy, P. F., Stijnen, T., Cuijpers, P., Penninx, B. W., &Zitman, F. G. (2010). Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Archives of general psychiatry, 67(3), 220-229.

McCaffrey, J. (2016). Plan water consumption in relation to energy intake and diet quality among US adults, 2005-2012. Journal of Human Nutrition and Dietetics, 29(5), 624-632.https://doi.org/10.1111/jhn.12368

Mujcic, R. and Oswald, A. (2016). Evolution of well-being and happiness after increases in consumption of fruit and vegetables. American Journal of Public Health, 106(8), 1504-1510. https://doi.org/ 10.2105/AJPH.2016.303260

Popkin, B, D’Anci, K, and Rosenberg, I. (2010). Water, hydration and health. Nutrition Reviews, 68(8), 439-459. doi: 10.1111/j.1753-4887.2010.00304.x

Saito, Y. and Tada, H. (2007). Effects of color images on stress reduction: Using images as mood stimulants. Japan Journal of Nursing Science, 4, 13-20. doi:10.1111/j.1742-7924.2007.00068.x

Sanderson, H., DeRousie, J., and Guistwite, N. (2017). Impact of collegiate recreation on academic success. Journal of Student Affairs Research and Practice, 55(1), 40-53. https://doi.org/10.1080/19496591.2017.1357566

Schaben, J. and Furness, S. (2018). Investingin college students: the role of the fitness tracker. Digital Health, 4, 1-10.10.1177/2055207618766800

University of Minnesota. (2007). Report on health and habits of college students. Retrieved November 29, 2017, from www.sciencedaily.com/releases/2007/11/071115125827.htm

Unusan, N. (2006). Linkage between stress and fruit and vegetable intake among university students: an empirical analysis on Turkish students. Nutrition Research, 26(8), pp.385-390.