Service-Learning for Health Promotion in Higher Education | Desklib

12/4/2018 Service-learning in Higher Education Relevant to the Promotion of Physical Activity, Healthful Eating, and Prevention of Obesity
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482993/?report=printable 1/19
Int J Prev Med. 2012 Oct; 3(10): 672–681. PMCID: PMC3482993
PMID: 23112892
Service-learning in Higher Education Relevant to the Promotion of Physical Activity, Healthful
Eating, and Prevention of Obesity
Richard R Rosenkranz
School of Science and Health, University of Western Sydney, and Department of Human Nutrition Kansas State University, Manhattan, KS 66506
Correspondence to: Dr. Richard Rosenkranz, 201 Justin Hall Kansas State University Manhattan, KS 66506 E-mail: [e-mail]
Received 2012 Jan 4; Accepted 2012 May 8.
Copyright : © International Journal of Preventive Medicine
This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Service-learning is a type of experiential teaching and learning strategy combining classroom instruction and meaningful community service and
guided activities for reflection. This educational approach has been used frequently in higher education settings, including an array of disciplines
such as medicine, theology, public health, physical education, nutrition, psychology, anthropology, and sociology. The purpose of the present
review paper was to provide guidance on the use of service-learning within higher education, relevant to the preventive medicine and public
health topics of healthful eating, physical activity, and obesity prevention. In service-learning, coursework is structured to address community
needs, and to benefit students through the real-world application of knowledge. The benefits for students include positive impacts on social
skills, empathy, awareness, understanding, and concern regarding community issues, plus greater confidence and skills to work with diverse
populations, increased awareness of community resources, improved motivation, and enhanced knowledge. Educational institutions may also
benefit through improved “town and gown” relations, as strong ties, partnerships, and mutually beneficial activities take place. The present
literature review describes several service-learning applications such as nutrition education for kids, dietary improvement for seniors,
foodservice recipe modification on a college campus, an intergenerational physical activity program for nursing home residents, motor skill

12/4/2018 Service-learning in Higher Education Relevant to the Promotion of Physical Activity, Healthful Eating, and Prevention of Obesity
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482993/?report=printable 2/19
development in kindergarteners, organized elementary school recess physical activities, health education, and obesity prevention in children.
From this review, service-learning appears to have great potential as a flexible component of academic coursework in the areas of preventive
medicine and public health.
Keywords: Community, health, learning, teaching
INTRODUCTION
Innovative strategies are needed in the education of health professionals as they prepare to address difficult lifestyle-related public health
problems such as physical inactivity, poor dietary habits, and obesity. Service-learning is an experiential teaching and learning strategy that
combines academic instruction with meaningful community service and guided reflection activities.[1] Students spend time serving at a
community site, working with people toward meeting an identified community need, and learning through the experience by applying classroom
knowledge to a real-world situation. Thus, in service-learning, coursework is structured to address community needs, while also benefitting
students through the application of knowledge. This strategic combination is designed simultaneously to provide a rich and engaging educational
experience, to promote social and civic responsibility, and to provide real benefit to communities.[2] Although service-learning may be included
in the student experience as an extracurricular activity, its close links to academic content makes it easy to justify a fully separate course, or
perhaps a substantial portion of an existing course.[3]
From a public health and social justice perspective, Ottenritter[4] has argued that service-learning can effectively allow students to consider and
address health disparities within the community. Ottenritter posited that the values, approach, and intended outcomes of service-learning align
well with disease prevention and health promotion efforts, and this allows institutions of higher education to contribute to a reduction in
observed health disparities within the community.[4] Similarly, Anderson and Colleagues[5] stated that public health, as a discipline, was well
suited for the use of service-learning, due to the focus on underserved populations, social justice, and community health.
Service-learning differs from both internships and volunteer work in that it designed to be mutually beneficial, community oriented, and closely
articulated with academic topics. Thus, service-learning is compatible with - and complementary to - most educational objectives and standards,
both general and discipline-specific.[6] Through this teaching and learning strategy, students are able to explore academic topics actively in real-
world settings, to learn to make decisions, to solve problems, and to gain professional experience while helping the community.
Historically, service-learning has been frequently used as a pedagogical approach in undergraduate education,[1] but more recently has expanded
to a variety of fields, including: public health,[5] health education,[6] nursing,[7] medical education,[8] theology,[9] physical education,[10]
nutrition,[11] psychology,[12] anthropology,[2] and sociology.[9] Thus, there are numerous examples of service learning, and also relevant
reviews available that collectively provide information relevant to the implementation and evaluation of service learning across several academic
areas of study. The pool of available studies, however, is reduced when looking at literature focused on service learning within a higher
education setting. To date, few literature reviews have focused on preventive medicine or the public health topics of healthful eating and physical

12/4/2018 Service-learning in Higher Education Relevant to the Promotion of Physical Activity, Healthful Eating, and Prevention of Obesity
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482993/?report=printable 3/19
activity or obesity prevention. Therefore, the purpose of the present review paper was to provide guidance on the use of service-learning within
higher education, specifically with regard to preventive medicine and public health topics of healthful eating, physical activity, and obesity
prevention.
IMPLEMENTATION OF SERVICE-LEARNING
Benefits of service-learning
Service-learning typically fosters an enhanced awareness of community resources, extending what students learn in the classroom to real-world
settings.[13] Students are likely to benefit from service-learning through improved motivation, enhanced knowledge, and better learning
outcomes.[14,15] Studies on service-learning have demonstrated positive impacts on social skills, empathy, awareness, understanding, and
concern regarding community issues, pro-social reasoning and decision making, plus greater confidence and abilities to work with diverse
populations.[12,13,15–17] At community placements, students can observe and interact with people and settings that help to elucidate academic
course content beyond what is possible in the classroom.[15] Such experiences may increase students’ self-esteem, personal competence, and
confidence.[18] Lastly, exposure to experiences in the community may help some students to develop greater self-awareness, or to find a
professional niche.[12,15]
Students are not alone in benefitting from service-learning. Faculty members may also enjoy many of the same benefits as students, including
deeper understanding of community issues, empathy, and real-world problem solving. Service-learning may also foster a dynamic learning
environment, better student engagement in class, and a stronger faculty-student relationship.[15] For some faculty members, service-learning can
enhance research and other scholarly activities.[15]
When carefully constructed by faculty members, service-learning can effectively integrate three major missions of the university: teaching,
research, and service,[2,19] although the research component is not seen as essential for most education-related outcomes. Academic institutions
and communities may also benefit from community outreach efforts and improved “town and gown” relations, as greater links, partnerships, and
mutually beneficial activities take place.[10,20,21] Lastly, inherent within carefully constructed activities, the achievement of benefits for some
portion of the community is an explicit goal of service-learning.[2]
Barriers and pitfalls of service-learning
The involvement of student placement sites and dealing with institutions or populations outside of the university realm adds complexity to an
academic course, and a number of issues need to be considered when planning a service-learning component. Academic instructors must ensure
that there are adequate resources and appropriate high-quality service-learning placements.[15] Indeed, some have cited that the lack of campus
or community resources, such as a university service-learning center, can pose challenges for those seeking to begin using this teaching and
learning strategy. Depending on the nature of activities and population involved, factors such as financial support, material costs, parking space,
child care, and incentives for involvement may be obstacles.[12]

12/4/2018 Service-learning in Higher Education Relevant to the Promotion of Physical Activity, Healthful Eating, and Prevention of Obesity
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482993/?report=printable 4/19
An academic instructor must also carefully consider the design and timeline of the academic course, as it may pose a serious challenge to fit a
service-learning component into an already densely packed curriculum.[13,15] The availability or coordination of student time poses one
limitation, and the amount of time faculty members spend planning, organizing, serving as liaison, and facilitating student education should not
be underestimated.[13,15] Also, it is important to match the skill level of students with the needs of the community placement site so that both
student and community needs can be met through the experience.[13] Finally, insufficient communication between students, academic instructor,
and other campus or community members has been identified as one pitfall to avoid for successful experiential education activities, so effective
lines of communication must be established, coordinated, and well utilized.[11,14]
The components of service-learning
Table 1 identifies seven key elements to consider when planning the implementation of a service-learning component in an academic course,
based on the work of Honnet and Poulson.[22] Significant deviations from these elements in the service-learning activities would likely
undermine the ability of the students, faculty, institution, and community to benefit fully from the arrangement of teaching and learning
activities. Rather than merely completing requisite hours or finding a convenient placement, it is imperative that students provide meaningful
service that meets a community-defined need for maximal learning and other benefits to be achieved.[15,22] It is also important that the service
is highly related to the topics of the course, and that academic instruction helps to prepare and frame the educational experience for the student.
[22] During ongoing service, and also after completion, it is crucial that students have the opportunity to reflect critically on the service-learning
experience, and to connect their thoughts to academic content from the course.[15,22] Such reflection provides the opportunity to provide
feedback on the experience, to think critically, and to explore and clarify values.[15] Studies have shown that the use of written and oral
reflection activities is predictive of student learning outcomes.[15] This critical reflection should be submitted to and evaluated by the academic
instructor, and course credit should be based on demonstrated learning apparent in the critical reflections of the student.[22]
Table 2 presents examples of academic instructor considerations regarding implementation and organization of an academic course with service-
learning, based on the work of Watson and Colleagues.[10] One of the first considerations regarding placement of students is whether the
students may self-select a community site, or whether instructors make arrangement on behalf of the students, and are there adequate spots for all
students. Either way, the placement site must present opportunities to address an identified community need corresponding with academic course
material. It is important to consider student skill levels, as well as the amount of time needed to fulfill needs of the community site and learning
activities. Lastly, communication issues should be sorted out in advance, including points of contact and how best to reach students and
community partners.[10]
With regard to coursework, academic instructors should consider selecting highly relevant readings and other useful academic materials to
prepare students for their placement.[10] Finding the right mix between theoretical and practical information may present difficulty, but course
organizers should consider what students will need to feel confident in starting their community work. As students embark on placement
activities, allowing them class time to share service-learning and other life experiences openly may help to bring academic course material to life
and serve to provide social support for other students who may have similar experiences or difficulties.[10]