Worksite Wellness Programs on the USA-Mexico Border. Conclusions and Recommendations
The majority of decisions regarding worksite wellness programs tend to be made by top administrators and persons in personnel/human resources/benefits departments. In order to expand the implementation of WWPs in the El Paso region, efforts must be directed at reaching top administrative personnel with the pertinent information. This information should include the data on improved health outcomes of participants in WWPs. The results of the study indicate that cost is the major barrier to the implementation of WWPs. Particular emphasis should be placed on the economic benefits of WWPs.
The information disseminated to top-level administrators could also be improved by the development of more rigorous evaluation approaches to assess economic benefits and health outcomes of worksite wellness programs. Information on the anticipated cost-effectiveness of worksite wellness programs is necessary in order for administrators to make sound decisions. A wider array of measurement strategies is advised. Past evaluations have been very specific and measured particular health outcomes. Broader evaluations may include measurements in general health outcomes as a result of participation in WWPs.
The results of this study indicate a lack of worksite wellness programs in small to medium-sized manufacturers. Future efforts by organizations dedicated to improving health at the worksite need to be tailored to meet the needs of small and medium sized companies. Smaller companies generally offer fewer worksite wellness program activities. This is generally attributed to the lack of staff and financial resources (Stokols et al., 1995). It has been projected that these barriers will decrease with managed care legislation mandating worksite injury and illness prevention programs (Stokols et al., 1995).
There are many organizations dedicated to the promotion of health-related activities at the worksite. Small and medium sized companies in El Paso who perceive cost as the major barrier to the implementation of a WWP should utilize the services and resources provided by these organizations. For instance, The National Association of Governor’s Councils on Physical Fitness and Sports is dedicated to the improvement of individuals health at the worksite (Prata, 1993). This organization offers creative worksite wellness program initiatives and developed a National Employee Health and Fitness Day.
In addition, the worksites of El Paso should utilize the services provided by the not-for-profit and voluntary agencies in the region. Not only does the local chapter of the American Cancer Society offer comprehensive cancer prevention and educational programs, but there is a program specifically designed to encourage and assist worksites in the development and implementation of their own WWP. These services are offered to worksites of any size and are free of charge or for a nominal fee. The El Paso Diabetes Association offers free educational programs to worksites and blood glucose screenings for a nominal fee. The local chapters of the American Cancer Society, American Heart Association, and American Lung Association offer similar preventive and educational services to worksites. Administrators interested in the improvement of employee health and the reduction of health related expenses can easily and affordably develop a worksite wellness program by utilizing services readily available in the El Paso community.
Worksite wellness programs must be designed to attract those employees with the greatest health concerns (Glasgow, McCaul & Fisher, 1993). It is also necessary to recognize the differences of demographic and behavioral risk factors in order to increase participation among employees with high-risk health behaviors. These health initiatives must address the needs of El Paso’s ethnically diverse population. Strategies must be incorporated to recruit this under-served group through the development of culturally and sensitive worksite wellness programs (Sorensen, Glasgow & Corbett, 1990).
Worksite Wellness Programs on the USA-Mexico Border. Discussion
Large worksite were much more likely to have WWPs. Worksite size also was a strong indicator of the number of worksite wellness program activities that were offered. Large worksites were more likely to offer more activities than small or medium sized worksites. This difference is perhaps due to a greater availability of resources (such as money, facilities, staff, etc.).
Employee’s perception of worksite wellness programs is of particular interest. The main benefits reported by respondents with existing WWPs were improved health and decreased health problems (83%) and decreased health care costs (70%). Conversely, the main barriers perceived by the contact person at the worksite where there was no WWP, were that implementation was too costly (38%). Cost may be perceived as the major barrier because companies without wellness programs may only consider the start-up costs. Understanding that, over the long term, WWPs might reduce costs, could alter this perception.
Of the thirty-four worksites without a WWP responding to the survey, only seven (21%) were interested in starting a WWP. However, when asked in a follow-up question, “Which of the following activities would this company be interested in implementing?,” 19 respondents (56%) were interested in initiating one or more of the listed activities. Perhaps the idea of implementing a “worksite wellness program” is more daunting than merely initiating one or more activities.
Of the activities of interest, emergency medical treatment and first aid (75%) and domestic counseling (70%) ranked among the highest. The interest in emergency medical treatment and first aid may reflect an effort to treat occupational injuries and illnesses that have occurred in the past and continue to occur. Perhaps a properly implemented injury prevention program could limit the number and/or the extent of these occupational injuries. A finding that was not anticipated was the level of interest in domestic counseling. This may reflect a major concern involving finances and family problems that have traditionally not been included in many worksite wellness programs, but are highly pervasive problems in today’s society.
The major limitation of this study is the lack of representation of worksites in the manufacturing industry of El Paso as evidence by the response rate of 11.8 percent. The low response rate in this study may indicate a lack of interest on the part of members of worksites in El Paso to participate in research involving wellness programs. However, the data collected provide a broad and interesting profile of the type of worksite wellness programs available in the manufacturing industry of El Paso, which accounts for approximately 19% of the El Paso labor force.
Worksite Wellness Programs on the USA-Mexico Border. Results
Sixty-four manufacturers responding to the survey with a response rate of 11.8%. In the thirty worksites with an active program, a total of 390 activities were reported as being offered. Worksite wellness program activities were categorized as healthy lifestyle education, screenings, monitoring and follow-up, safety promotion and accident prevention, and employee assistance programs (Table 1). Under the category of healthy lifestyle education, 80% offered activities on lifting properly. Diabetes screening (63%), immunization (e.g., tetanus booster), (53%) and heart disease risk identification (50%) were the most frequently offered screenings, monitoring, and follow-up activities. The vast majority of activities offered by companies fell into the safety promotion and accident prevention category. The majority of the companies offered emergency medical treatment and first aid (93 %), on-the-job safety instruction (86%), and “right-to-know” education (identify potentially hazardous substances) (75%). Of the employee assistance programs (EAPs), alcohol and other drug abuse counseling was offered by 73% of the companies. Less than half of these companies offered EAPs covering preparing for retirement, coping with depression, and domestic counseling.
The mean number of activities varied significantly with the size of the worksite (F = 7.97, df = 2, 27, p ≤ 0.0019). Large worksites offered significantly more activities than small or medium sized worksites. The mean number of activities for small worksites was 10, medium 6, and large 15.
The thirty manufacturers with a worksite wellness program were asked to cite the reason or reasons for the implementation of their program. The vast majority (83%) of the respondents reported improving health as the reason for implementing a worksite wellness program. Well over half (70%) of the companies cited both improving employee morale and decreasing health care costs as reasons.
The thirty-four respondents without existing worksite wellness programs were asked to cite the reason or reasons why their worksite did not have a WWP. The most common response, “Too costly,” was cited by 38% of the respondents. Respondents also cited “employees do not show an interest” (35%), other reasons (29%), and “no need/employees healthy” (24%). The “other” category was an open-ended question and allowed the respondent to express an individual response. Other reasons included: “too small an operation,” “too many other issues to worry about,” “uninformed,” and “it is a useless proposition.” Four manufacturers (12%) said they had not initiated WWP because they felt it would interfere with workday routine, would be too time consuming, they had high employee turnover, and it would be too difficult to implement. “No perceived benefits” was a reason reported to a much lesser extent (9%).
Worksite Wellness Programs on the USA-Mexico Border. Part 2
The population of El Paso County is approximately 679,622 (US Census, 2002). The El Paso community reflects the health concerns of other Latino populations in the United States. “Activity limitation, infectious disease, chronic disease, and poor nutritional status” are health concerns of the Latino community (Carter-Pokras, 1994, p. 45). El Paso has been characterized as rapidly expanding, predominantly Hispanic, primarily young, and economically disadvantaged (Michie, 1992). The manufacturing industry employs 18.6 percent of the El Paso workforce, yet there is no information about the worksite wellness programs implemented to address the health concerns of this vulnerable population (City of El Paso, 1996).
Methodology
Selection and Recruitment of Study Population
In order to identify current worksite wellness programs in practice, determine the types of activities available, and identify perceived benefits or barriers to the implementation of worksite wellness programs in El Paso, Texas, a survey of the manufacturing industry of El Paso was conducted. The manufacturing industry was selected for the study because it employees 18.6% of the labor force of El Paso (City of El Paso, 1996). The target population was all manufacturers in El Paso county, registered with the El Paso Chamber of Commerce. The questionnaire with a letter inviting participation and assuring confidentiality was sent to the contact person of these 577 manufacturing companies. The instrument was approved by The Committee for the Protection of Human Subjects at The University of Texas Houston Health Science Center, A self-addressed stamped envelope was enclosed with the instrument in order to increase the response rate.
Instrument Development
The survey was developed after a review of the literature on worksite wellness programs. The first question of the survey requested information about the existence of a worksite wellness program and the size of the company. The questionnaire was then divided into two parts. Manufacturers without a WWP were asked to complete six questions covering the reasons the company did not have a WWP, if their company would be interested in implementing a WWP, the reasons for their interest, and what specific activities were of particular interest (Chenoweth, 1987). The second part of the survey requested manufacturers with an existing WWP complete a series of questions regarding the reasons for implementation, types of activities offered, and utilization of nonprofit services.
Data Analysis
Data from completed questionnaires were entered into an SPSS database. Manufacturers were divided into small, medium, and large companies based on the number of employees. Small companies were defined as manufacturers employing less than 50 persons. Companies with 50 to 299 employees were defined as medium sized companies. Large companies were defined as those with over 300 employees. An analysis of variance (ANOVA) was performed to determine if a significant difference existed between the size of the worksite and the number of programs offered. The alpha level set for this ANOVA was ≤ 0.05.
Worksite Wellness Programs on the USA-Mexico Border
Worksite wellness programs (WWPs) have the potential to reduce absenteeism, increase productivity, and improve employee attitudes and job performance with distinct economic benefits. The purpose of this study was to collect data about WWPs in the manufacturing industry in El Paso, Texas and formulate recommendations to increase the use of WWPs to protect, promote and improve the health of this workforce. RESULTS: The results of this study indicate a lack of worksite wellness programs in small to medium-sized manufacturers. Worksite size was a strong indicator of the number of worksite wellness program activities that were offered. Large worksites were more likely to offer more activities than small or medium sized worksites. This difference is perhaps due to a greater availability of resources (such as money, facilities, staff, etc.). Administrators perception of worksite wellness programs is of particular interest. The main benefit reported by respondents with existing WWPs was improved health and decreased health problems (83%) and decreased health care costs (70%). Conversely, the main barrier perceived by administrators at sites lacking WWPs was that implementation was too costly (38%). Cost may be perceived as the major barrier because companies without wellness programs may only consider the start-up costs. Information on the long-term economic benefits of WWPs could alter this perception. Future efforts to initiate worksite wellness programs must be tailored to meet the needs of small and medium sized companies in this border community.
Background
Currently, employers pay approximately one-third of the national health care bill (Reardon, 1998, Ahrens, 1995). Preventive measures are being employed by businesses in an effort to contain the escalating costs of employee illness. In the United States, an estimated 110 million persons are employed, and spend approximately one-third of their time at the job site (Reardon, 1998; Stokols, Pelletier & Fielding, 1995). Because eighty-five percent of the adult population of the US is employed, the worksite is an ideal setting to implement a health promotion program. Worksite wellness programs have the potential to improve the health of the employee and their dependents. The most common health promotion activities include: smoking cessation, stress management, health risk assessment, cardiovascular risk reduction, weight control, and exercise and fitness (Kizer, Pelletier & Fielding, 1995).
Numerous studies have concluded that properly implemented WWPs can improve employee health outcomes and have economic benefits (Wellness Councils of America, 1994, Stead, 1994). Worksite wellness programs have the potential to reduce absenteeism, increase productivity, and improve employee attitudes and job performance (Conners, 1992; Fowler & Risner, 1994; Mason, 1992). Twenty-four peer-reviewed studies published from 1980 to 1991 concluded that positive health outcomes result from the implementation of worksite wellness programs (Kizer, 1995). An additional twenty-four peer-reviewed studies published from 1991 to 1993 indicated positive health outcomes relative to smoking cessation, weight loss, and the reduction of coronary heart disease risk factors (Kizer, 1995).
Methodology
This was a cross-sectional descriptive study conducted to assess methodologies used by a national sample of universities to determine and assign faculty workload in health education programs. Human subjects approval was obtained from the university human subject committee.
Sample
A total of 106 surveys were distributed by mail to department chairs or program directors of Health Education programs at various universities across the country. Programs and contact people were identified through the use of discipline specific program directories and a review of university web sites.
Data Collection
For the purpose of data collection a 21 item survey instrument was developed. The survey was designed to collect data on a number of factors including institutional type (location, funding, Carnegie classification, etc.) types of programs offered, number of students and faculty, and measures of workload. The instrument was internally pre-tested and pilot tested among various administrators.
Carnegie Classification
The Carnegie Classification of Institutions of Higher Education is a taxonomy of U. S. Higher education institutions that was developed in the early 70’s. The purpose of which was to identify categories that would be relatively homogeneous with respect to the functions of the institutions. Although the criteria for classification takes into account many factors, the primary components have historically been the amount of federal research dollars an institution brings in and the types and number of degrees granted (McCromick, 2000). In 2000, the classification system was modified slightly and institutions were reclassified based on their degree-granting activity from 1995 to 1998. Because many University personnel are not familiar with the new classifications, for the purpose of this study the traditional classifications were used. The primary change was the reduction of Doctoral degree granting institutions from four categories to two. Universities are now classified based on the number of doctoral degrees granted and the number of disciplines for which doctoral degrees are available. The institutions sampled for this study were distributed across Carnegie classifications with 56% identified as Research or Doctoral Universities and 34% as Master’s level institutions.
Data Analysis
Survey data was entered manually and all analysis was done using SPSS 10.0 for Mac. Descriptive statistics including frequency distributions, means and standard deviations were conducted on all variables.
Results
Of the 106 initial surveys, 30 surveys were completed and included in the final analysis for a response rate of 28.3%. Of the 30 institutions responding to the survey, 53% were in urban settings and 90% were public. 31% designated a Carnegie Classification of Research University I.
Of the health education programs that responded to the survey, many had multiple programs within their departments and schools. The data presented in Table 2 illustrates the number of respondents who stated that they offered the following degrees at the identified discipline
75 J. E. Cowdery & A. Agho / Californian Journal of Health Promotion 2007, Volume 5, Issue 3, 73-79 levels (undergrad, master’s, doctorate). Within each level the percent is a reflection of the percentage of the total programs offered at that level. The majority of degrees offered were B.S. (58%) and M.S. (48%) degrees.
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Faculty
The majority of health education faculty work on a semester calendar (93%) and hold nine-month appointments (65%).
Measuring Workload Among Health Education Faculty. Part 2
For decades the credit hour was used primarily as a measure of workload specific to teaching instruction. Ehrlich (2003) posits that although the credit hour may work well enough when lectures and the fifty-minute hour predominate, the application of such a rigid measure of faculty work may serve to limit innovation in teaching. This in addition to it not being applicable to the measure of additional faculty responsibilities such as research and service. Historically issues have arisen in areas of interdisciplinary teaching, team teaching, and more recently the use of technology including on-line teaching and the incorporation of service learning into the student experience.
Originally developed in 1969 and revised in 2000, The American Association of University Professors (AAUP) Faculty Workload Statement states that the maximum teaching load for effective instruction at the undergraduate level is a teaching load of twelve hours per week and a load of nine hours per week for instruction at the graduate level (AAUP Staff, 2000).
External pressure on colleges and universities for full disclosure regarding faculty productivity is not going away any time soon (Middaugh, 2002). Although some states have managed to escape legislative interference for now, not all institutions have been so fortunate. A 1996 AAUP report found that 21 states had some kind of mandate related to faculty workload (Euben, 2003). Mandates vary from requiring annual reporting on such issues as number of hours spent by faculty members advising students, and the percentage of lower division courses taught by senior professors to mandates that full-time faculty members of state universities who are paid entirely from state funds teach at least 12 contact hours per week (Winkler, 1992). According to Porter & Umbach, one of the most salient policy issues in higher education has been the regulation of faculty work (Porter & Umbach, 2001). Historically, faculty workload is examined either due to the political climate, in order to facilitate collective bargaining agreements for unionized faculty, as a consequence of budgetary issues or in response to the lay media’s request for accountability of tax payer dollars.
Although a fair amount of discussion has occurred in the lay press, surprisingly little has been published in academic publications. The few studies which have been published deal almost exclusively with business management education and no studies were found that examined faculty workload in health education (Comm & Mathaisel, 2003; Lau, 1996). In an attempt to address this void and to provide administrators with comparison data, this study of faculty workload in health education was undertaken.
Measuring Workload Among Health Education Faculty
Legislation nationwide has mandated millions in funding cuts to state funded universities over the past several years. Additionally, university administrators frequently find themselves in the position to quantify faculty workload and productivity. The purpose of the study was to assess methodologies used by a national sample of universities to determine and assign faculty workload within health education programs. Methods included a cross-sectional descriptive study conducted utilizing a mailed survey to 106 department chairs or program directors of Health Education programs at various universities across the country. Results showed that the majority (87%) of health education programs reported using credit hours as a measure of faculty workload (rather than contact hours). For undergraduate health education faculty 12 credit hours was the typical teaching load for 54% of respondents while 35% taught nine or less credit hours. For graduate health education faculty 48% had a full time teaching load of nine hours or less while 37% reported 12 credit hours as a full time load. At the undergraduate level, administrators allocate the majority of faculty time for teaching (61% of effort) while at the graduate level the effort allocation was slightly shifted toward research with teaching occupying 58% of faculty time. It is anticipated that the results of this study will assist faculty and administrators in making informed decisions regarding faculty workload assignments.
Legislation nationwide has mandated millions in funding cuts to state funded universities over the past several years. Additionally, university administrators frequently find themselves in the position to quantify faculty workload and productivity. In an effort to assist administrators in making informed decisions regarding faculty workload assignments the following study was initiated. The purpose of the study was to assess methodologies used by a national sample of universities to determine and assign faculty workload within health education programs.
The student credit hour has been an integral component of higher education for over a century. In a review of the history of the student credit hour, Shedd (2003) describes the invention of the credit hour as a tool for smoothing transitions from high school to college. This concept was reinforced by multiple foundations including the Carnegie Foundation for the Advancement of Teaching, to encourage the adoption of business models including unit-cost analysis in higher education. Initially a measure of student learning the credit hour evolved into a measure of faculty time. Although the Carnegie unit was originally devised by a committee appointed by the National Education Association, the Carnegie foundation played a key role in the dissemination and adoption of the unit. In an effort to calculate eligibility for the retirement pensions provided by Andrew Carnegie the Carnegie unit was defined and accepted in 1909 (Shedd, 2003). The following year Morris L. Cooke developed a formula to estimate the cost and output of teaching and research to measure the efficiency and productivity of education institutions. Cooke defined a student hour as “one hour of lectures, of lab work, or recitation room work, for a single pupil” (Barrow, 1990, p. 70). This enabled relative faculty workloads to be calculated and was used by all colleges applying for the Carnegie Foundation pension system. As public educational institutions were increasingly pressured to justify their productivity the student hour became the basic measure of production (Shedd, 2003).
Healthy Lifestyle in a College Population. Part 3
Only a small percentage of college students are consuming the recommended number of servings for fruits, vegetables, and dairy (Hiza & Gerrior, 2002; Georgiou et al., 1997). In the present survey, 58% and 64% of the participants state they consume vegetables or whole or canned fruit less than once per day, respectively. This agrees with the 51% of participants who rate the “healthiness” of their eating habits as poor or fair. Dinger and Waigandt (1997) surveyed over 2,600 college students and found that 40% had not eaten any fruit in the previous 24 hours and 55% had not eaten green salad or cooked vegetables. According to a study by Debate et al. (2001), in a population of 630 college students, only 18% consume five servings per day of fruits and vegetables, 7% consume six or more grain products, and 53% consume two or more dairy products. An earlier study by Melby et al. (1986) reported that 69% of college students do no eat any fruit once a day and 48% eat vegetables less than once a day. These findings are cause for concern because there is ample data suggesting that fruit and vegetable consumption may be protective against most cancers and cardiovascular disease. The decreased risk of chronic disease associated with a plant-based diet may be due to substances in fruit and vegetables such as antioxidants, folate, fiber, potassium, flavonoids and numerous other phytochemicals (Hyson, 2002; Van Duyn & Pivonka, 2000).
The most common barrier cited to eating well is “lack of time.” Other common reasons are “lack of money” and “taste preferences.” Lopez-Azpiazu et al. (1999) examined perceived barriers of healthy eating among 1009 Spanish adults, over the age of 15 years, and found the common barriers were “irregular work hours,” “willpower,” and “unappealing food.” Lappalainen et al. (1997) reported that “irregular work hours,” “giving up foods I like,” and “willpower” are the most common barriers to trying to eat healthier in a large study with over 14,000 European adults, 15 years of age and older. The present survey noted some differences in barriers between men and women. More women state “lack to time,” while three times as many men state “don’t care.”
The steepest decline in physical activity occurs during adolescence and young adulthood (Allison et al, 1999; Grace, 1997; Leslie et al., 1999). Pinto and Marcus (1995) report that 46% of young adults on college campuses are inactive or active irregularly and only about 35% have a regular schedule of physical activity. This is similar to results of Dinger and Waugandt (1997) who found that 30% of college students did not engage in moderate physical activity the previous week and only 45% report participating in vigorous physical activity. Haberman and Luffey (1998) also state that only 39% of 302 college students exercise enough to meet the Healthy People 2000 goal for activity. In contrast, in this particular population of college students, 84% state they currently exercise. However, it should be noted that exercise (frequency or intensity) was not defined. Despite this high reported rate of activity, 42% state they exercise less since attending college. Leslie et al. (1999) found that about 70% of a population of over 2,700 college students report less activity at college. Men exercise more frequently and at a greater intensity level than women and men select strength-training and competitive sports more than women. Women select aerobics more than men. These gender differences also are reported by Leslie et al. (1999) and Pinto and Marcus (1995).
The main reason participants’ exercised in this survey was for “health.” Among other stated reasons, women exercise because of weight and stress reduction and men exercise for enjoyment and gains in muscle and strength. Similarly, Myers and Roth (1997) found that college women exercise for its psychological and body image benefits and Leslie et al. (1999) found that men are motivated to exercise for muscle gain. Not surprisingly, 38% of male students felt confident with how their body looked compared with only 16% of female students. In a survey of 630 college students, almost 50% of white and 25% of African American females, who fell within an acceptable BMI range (19-25), desire to be in the underweight range. These results suggest that college-aged women are dissatisfied with their current body size (Nutrition Research Newsletter, 2002). Adolescents state that “time,” “lack of interest/other interests,” “not in the mood,” and “lack of energy” as common barriers to exercise (Allison et al., 1999; Tappe et al., 1989) The present survey found that the most commonly cited barriers to exercise were “lack of time,” “lack of motivation,” and “lack of willpower.”
The current study suggests that there is much room for improvement in the diet and exercise habits of this college-aged population. Gender specific interventions may be warranted given the evidence that different barriers to healthy eating and exercise exist between male and female students. In addition, with “lack of time” the most frequently mentioned barrier to eating a healthy diet and engaging in regular exercise, the challenge becomes developing and evaluating interventions that are not only appealing and motivating to this demographic, but also will fit within their time constraints. Health advocates should take advantage of the opportunity that exists for building a foundation of lifelong healthy diet and exercise habits among college students thereby reducing their future risk of chronic disease.
Dietary Habits and Perceived Barriers to Healthy Eating
The purpose of this survey was to assess the diet and exercise habits and perceived barriers to following a healthy lifestyle of college students and to determine if differences exist by gender. The survey population is young; most students are 21 years of age or younger, and there are a fairly even distribution of students by class standing. Twenty-five percent of students have a body mass index (BMI) placing them in the overweight category and 6% are classified as obese. In close agreement with the current survey, Lowry et al. (2000) report that 35% of college students are overweight or obese based on the 1995 National College Health Risk Behavior Survey. In contrast, Haberman and Luffey (1998), in a population of 302 college students, report that 8% are overweight. Female students in this survey population have a similar incidence of overweight (20%) as that reported by Anding et al. (2001) in a small population of 60 female students (25%). While 40% of men in this survey have a BMI greater than 25, 19% of these men report that they strength-train and 41% report they do a combination of exercise. Many of these men may have a greater proportion of lean body mass. Self-reported height and weight data must be viewed with caution as Jacobson and DeBock (2001) recently reported that college men underestimate height and college women underestimate weight.
Many college students have poor nutritional habits (Georgiou et al., 1997). Most do not meet the minimum recommended intake of dietary fiber, fruits, and vegetables; and exceed recommended intakes of total fat and saturated fat, sugar, and sodium (Anding et al., 2001; Grace, 1997; Hiza & Gerrior, 2002; TLHS, 2000). Thirty-three percent of this survey population report they consume breakfast “never” or “seldom.” Hertsler and Frary (1989) studied food behavior among 212 college students where 43% report skipping breakfast more than half the time. Eighty percent also indicate that they snack one to three times per day while 4% note four or more times per day. In the present survey, 63% are inclined to snack one to two times per day, 26% three to four times per day and 5% four or more times per day. “Boredom” was the most frequently cited reason for snacking. The present survey also found gender differences in types of snack foods and additional reasons for snacking. Men state “partying” as a reason for snacking more frequently than women and women state “emotional” more frequently than men. While most students snack on chips, crackers, or nuts; men snack on fast foods more and on ice cream, cookies and candy less frequently than women. Twenty-six percent of women and 38% of men in the current study report drinking regular soda or other sugared beverages one or more times per day. While the authors defined a serving as equaling one cup, it is clear that most students purchase much larger sodas; the standard serving sold on campus is 20 ounces.
Larger portion sizes leading to significantly increased caloric intake are implicated in the national obesity epidemic (Young & Nestle, 2002). Soda may be just one source of excess calories in the college students’ diet. A recent study (Lang, 2003) suggests that the “freshman 15,” the gain of 15 pounds of weight by freshman during the first year of college, may be a real phenomenon fostered by “all you can eat” dining facilities, evening snacks, consumption of junk food, and dieting. It is reported that nation wide binge-drinking among college students exceeds 40% (Grace, 1997). Men are heavier drinkers than women in the present survey where 15% state they usually drink 22 or more drinks per week. Wechsler et al. (Wechsler & Isaac, 1992; Wechsler et al., 2000) also confirm that male students drink more frequently than female students.