Date of Award


Document Type

Independent Study

Degree Name

Master of Science in Nursing (MSN)


Peer/health advocacy programs are used in the college and university setting to promote health education for students. Carns, Carns, and Wright (1993) found 83% of colleges and universities used undergraduate students in peer education programs. According to Mellanby, Rees, and Tripp (2000), "Peer-led education may be more effective, resulting in greater positive changes in health behaviour, than adult-led interventions" (p. 543). In the spring of 2005, Dr. Alan Allery, Director of Student Health Services at the University of North Dakota (UND), envisioned implementing a peer advocacy program at UND. A review of peer/health advocacy programs at other universities revealed that a class in health advocacy prepared students to become peer leaders. Student Health Services consulted campus leaders and partners, who ultimately set forth the objectives for two new courses, Health Advocacy I & II, which were offered through a partnership between the College of Nursing and Student Health Services. Health Advocacy I was piloted fall of2006 and Health Advocacy II was piloted in spring of 2007

College students are a vulnerable population in regard to their health care. Often on their own for the first time, students are adapting to a new environment that provides greater freedom and control over their lifestyles. This becomes an opportune time to establish healthy lifestyle behaviors. College students are good candidates for health promotion and prevention education, which may have a lasting lifetime influence on their health (Ah, Elbert, Ngamvitroj, Park, & Kang, 2003).

Risk behaviors of young adults identified by the Centers for Disease Control (CDC) included intentional and unintentional injury, tobacco use, alcohol and drug use, sexual behaviors, unhealthy dietary behaviors and physical inactivity (CDC, 1997). The four leading causes of death among young adults are from preventable causes, motor vehicle crashes, unintentional injuries, homicide and suicide (Grace, 1997). Obesity, lack of exercise, alcohol use, tobacco use and unsafe sexual practices are preventable causes of many long-term heath related problems that occur later in life (Ah et al., 2003 ).

Nola Pender's Health Promotion Model (HPM) was the framework for this project. The RPM uses seven cognitive-perceptual factors and five modifying factors to explain and predict health behaviors (Pender, Murdaugh and Parsons, 2006). According to Pender et al., "Awareness of benefits of adopting a healthy behavior or discontinuing a risk behavior is enhanced through seeking and processing information, observing others, and interpreting information in light of one's personal situation" (p.57-58).

The purpose of this project was to identify a tool to evaluate the changes in health behaviors experienced by the students enrolled in the health advocacy classes. Several tools were available to test college age students' wellness behaviors. The TestWell® tool, based on the Six Dimensions of Wellness (Testwell, 2000), most closely mirrors the Seven Dimensions of Wellness used at UND to promote healthy behaviors on campus

Although many wellness behavior tools exist, little research has been done in the application of these tools to measure the outcomes of a health promotion class. Health educators would benefit from the expanded knowledge concerning the development of health and wellness education to students of this age level. There is currently little research available in the area of health advocacy courses offered at the college level