A Realist Review of Effective University-Based Wellness Programs on Physical Activity, Occupational Balance, and Vocal Health

Abstract

Background: Wellness programs can be implemented in a university setting and may include varied elements such as physical activity, occupational balance, and vocal health. However, there is limited information that highlights and synthesizes why and how these programs work. Therefore, this study aimed to understand effective programs on physical activity, occupational balance, and vocal health for university constituents in relation to the implementation contexts, mechanisms, and outcomes (CMO).

Methodology: Guided by the Health Belief Model in the context of a realist review design, the researchers conducted an iterative search among seven peer-reviewed electronic databases in the health and education fields using a predetermined set of eligibility criteria.

Results: The search identified 6564 records, of which programs from 20 records contributed to data synthesis. Nine CMO statements were created, with physical activity programs accounting for most configurations. Key themes identified were tailored and individualized interventions, medium-term incentivization, lifestyle education programs utilizing information and communications technology, interdisciplinary multi-component programs, use of self-monitoring strategies, social support, and shared experiences among employees and students. Analysis of the mechanisms of these effective university programs revealed processes and structures that were consistent with elements of the Health Belief Model.

Conclusion: Effective university-based wellness programs on physical activity, occupational balance, and vocal health result from a health-supporting culture among staff and students, utilizing self-based, technological, and social approaches that target and address individual and organizational needs. This realist review provides practical information that may guide the development of university-based programs and policies targeting these areas of wellness.