This document describes an innovation used at Bowling Green State University to engage first-year college students in discussions about health. Researchers collected health data from students and originally provided individual paper feedback sheets. They created 15 animated case study videos based on common health issues in the transition to college. The videos were used to spark classroom discussions among students. Feedback showed the videos helped students feel less alone in experiencing health issues and increased understanding versus static data. The approach represents a new way to promote chronic disease prevention among young adults through peer engagement and self-care.

1. Health Promotion Practice
Month XXXX Vol. XX, No. (X) 1­–4
DOI:https://doi.org/10.1177/1524839919874053
Article reuse guidelines: sagepub.com/journals-permissions
© 2019 Society for Public Health Education
1
Practice Notes
While the college years present an ideal time for chronic
disease prevention, students often do not seek services
or perceive themselves to be at health risk. Researchers
at Bowling Green State University have been exploring
the health patterns of first-year university students for
several years, initially as a health-based research study
(August 2012 to May 2016) and currently through a first-
year seminar course for students transitioning from high
school to college (August 2016 to present). This article
describes the evolution of data sharing techniques from
passively presented paper feedback sheets (focusing on
individual health assessments) to highly interactive
classroom discussions stemming from viewings of ani-
mated case study videos (designed based on whole
group themes). Qualitative feedback from students and
faculty has been positive, suggesting that animated case
study videos are an effective strategy for engaging stu-
dents in critical thinking about physical and mental
health concerns affecting their peer group. Practical rec-
ommendations for using animated case studies in
diverse educational settings are provided.
Keywords: health education; technology; university/
college health
>>Introduction
While the college years present a reachable moment
for health risk reduction, traditional strategies (e.g., lec-
tures, readings) designed for older individuals have ques-
tionable effectiveness among young adults (Xie et al.,
2016). Despite associating modifiable health behaviors
(e.g., diet, exercise) with heart disease risk, college stu-
dents estimate their own future risk as below average
(Wendt, 2005). Young adults view social influences and
appearance as key motivators for behavior change related
to weight management, identifying peer support as vital
(LaRose, Leahey, Hill, & Wing, 2013).
In addition to physical health risks, a growing con-
cern on campuses involves mental health. Most students
who experience mental health concerns do not seek
counseling. Thus, course-based experiences represent
an ideal time to address mental health. Active teaching
methods (e.g., role play, simulations, interviewing) have
shown promise for engaging younger generations with
health topics (Xie et al., 2016).
874053HPPXXX10.1177/1524839919874053HEALTH PROMOTION PRACTICETraxler et al. / ANIMATED CASE STUDIES TO EXPLORE HEALTH
research-article2019
1
Bowling Green State University, Bowling Green, OH, USA
Authors’ Note: This study was supported by grants from the Ohio
Department of Higher Education’s Transforming Campus Climate
Grant, Medical Mutual/Bowling Green State University’s Center of
Excellence for Health and Wellness across the Lifespan’s Health
and Wellness Innovation and Collaboration Grant, and Bowling
Green State University’s Center for Undergraduate Research and
Scholarship. Funding agencies did not participate in innovation
development or manuscript preparation. Address correspondence
to Mary-Jon Ludy, Department of Public and Allied Health, Bowling
Green State University, 135 Health and Human Services Building,
Bowling Green, OH 43403, USA; e-mail: mludy@bgsu.edu.
Animated Case Study Videos: A Creative
Approach for Exploring Health in the
High School to College Transition
Elizabeth G. Traxler, BS1
Amy L. Morgan, PhD1
Jessica E. Kiss, PhD1
Mary-Jon Ludy, PhD, RD1

2. 2 HEALTH PROMOTION PRACTICE / Month XXXX
Case studies are one approach for actively engaging
students in critical thinking about real-life situations
(Popil, 2011). Likewise, integration of educational tech-
nologies can strengthen engagement by utilizing ani-
mated visuals, rather than static images, to convey
procedural motor knowledge (Höffler & Leutner, 2007).
The unique approach described here uses a combination
of case-based teaching and animation to engage students
with data about health risks that occur during the transi-
tion from high school to college.
>>Description of Innovation
First-Year Student Health Data
Researchers at Bowling Green State University have
been exploring the health patterns of first-year univer-
sity students, initially as a research study (August 2012
to May 2016) and currently through a first-semester
seminar course for students transitioning from high
school to college (August 2016 to present). Students
without a major-based introductory course enrolled in
one of approximately 60 themed seminar courses during
summer orientation. Course design was instructor
driven, with eligibility for all majors and sections capped
at 20 students.
The university’s institutional review board approved
these investigations and participants provided informed
consent. Data collection included physical assessments
(i.e., height, weight, body fat, body mass index, cardio-
vascular fitness, muscular endurance, flexibility, blood
pressure, cholesterol) and wellness questionnaires (i.e.,
sleep duration/quality, diet quality, intuitive eating,
mindfulness, alcohol consumption, depression, stress).
Data consistently exhibited decreases in health status
among first-semester students (Ludy, Crum, Young,
Morgan, & Tucker, 2018).
Approaches to Sharing Data
The primary means of sharing participants’ data from
2012 to 2017 was a paper feedback sheet. This detailed
students’ individual measurements from the beginning
(August/September) and end (November/December) of
their first semester. Interpretation was provided on a scale
to help students quantify their findings (e.g., mean score
and percentage of students categorized as “at risk”).
Descriptions were displayed below each measurement to
help students understand their personal risks and provide
resources (e.g., personal physician, counseling center).
Although the feedback sheet presented data and
information on how to improve health, this method did
not actively engage students. Sheets were shared pri-
vately. While students were encouraged to talk with
researchers/instructors, few students did. Moreover, cer-
tain health indicators may be difficult to understand
without proper instruction (e.g., body mass index).
Therefore, the feedback sheets were limited in their
effectiveness.
Fifteen 2- to 3-min video case studies were created
based on preliminary data, as well as common issues
reported during the transition from high school to col-
lege (the entire video archive may be viewed at https://
tinyurl.com/CaseStudyArchive). Topics included phys-
ical health (e.g., disordered eating), mental health (e.g.,
depression), and transitional issues (e.g., newfound
independence). Character development stemmed from
a design-thinking workshop; feedback guided creators
in designing animated videos to appeal to first-year stu-
dents. After writing each case study, the story was
adapted to a video using a cloud-based whiteboard ani-
mation platform (https://www.animaker.com/), requir-
ing 90 to 120 min of creation time for experienced users.
Academic advisors, administrators, professors, resi-
dence life personnel, and wellness program staff
reviewed content.
Videos were paired with course content and campus
events throughout the 15-week semester. Sequencing
was based on discussions between professors and resi-
dence life personnel. Students viewed videos and
engaged in discussion with peers using the think–pair–
share format (Kaddoura, 2013). This model was selected
based on research demonstrating improvements in crit-
ical thinking skills (e.g., ability to make decisions using
rationale and evidence after viewing lecture videos and
participating in a flipped classroom) among health stu-
dents. Viewings occurred during the first or last 15 to
20 min of weekly 2-hour class meetings. These were
often paired with visits from guest experts able to help
students think outside their personal experiences and
develop an understanding of the larger social–ecological
context shaping individual health behaviors. For exam-
ple, students viewed the “food insecurity” case study
after a class trip to the dining hall focused on food waste
and facilitated by leaders from a hunger-focused student
organization. This preceded a food-focused documen-
tary screening facilitated by committee members of the
campus food insecurity initiative.
>>Lessons Learned
Three major themes emerged from student feedback.
1. Health awareness initiatives are relevant to college
students.
Talking about real issues is something I appre-
ciate because many of these topics are not
discussed enough.

3. Traxler et al. / ANIMATED CASE STUDIES TO EXPLORE HEALTH 3
Practice Notes
Generally, people only tend to really care for
their overall health when it has already
become a problem.
2. Health issues are commonly experienced in the tran-
sition from high school to college.
The topics covered were extremely relatable
. . . These topics make you feel like you aren’t
alone.
3. Animations are a well-accepted approach for engag-
ing college students.
The animations were funny and lighthearted
when they needed/could be, but allowed
students to relate it to their own life rather than
trying to interpret numbers on graphs from a
research paper. It increased understanding,
especially after small group discussions.
>>Implications for Practice
Based on student feedback from the first-year semi-
nar course, a health-based research methods course for
upper-level students, and university symposia on diver-
sity and sexual assault, additional strategies for facilitat-
ing discussions were developed. These are shown in
Table 1 and ordered by sensitivity. For example, while
think-pair-share may generate good discussion for topics
like study skills, more sensitive topics like sexual assault
benefit from the anonymity offered by note cards and
technology platforms. Additionally, end-of-semester
Table 1
Techniques for Stimulating Class Discussion
Strategy Implementation
Think–pair–share 1. Think: While the whole class views the case study, students independently identify red
flags and/or brainstorm intervention strategies.
2. Pair: Students discuss thoughts and ideas in pairs or small groups. Instructor moves
from group to group.
3. Share: Students share ideas with the whole class. Alternate option for more sensitive
topics: Instructor shares what has been overheard when rotating from group to group.
Index card shuffle 1. While the whole class views the case study, students anonymously write their thoughts
and ideas on a note card.
2. The instructor collects the cards and shuffles them and redistributes them.
3. Students pass cards around the classroom so that every student has the opportunity to
read every card. Alternate option: Students read aloud the new card they have been given.
4. The whole class discusses the case study.
Technology platforms 1. While the whole class views the case study, students independently identify red flags
and/or brainstorm intervention strategies.
2. Anonymous share: Students use a technology platform to pose questions, answer
questions, or chat. Sample platforms with (limited) free options for educators are listed
below.
a. Respond to questions posed by the instructor.
i. Answer Garden: https://answergarden.ch
ii. Nearpod: https://nearpod.com
iii. Poll Everywhere: https://www.polleverywhere.com
iv. Slido: https://www.sli.do
v. Socrative: https://socrative.com
vi. Vevox: https://www.vevox.com
b. Pose questions that can be priority voted by other students.
i. GoSoapBox: https://www.gosoapbox.com
ii. Mentimeter: https://www.mentimeter.com
iii. Zeetings: https://www.zeetings.com
c. Chat about a topic.
i. Backchannel Chat: http://backchannelchat.com
ii. YO Teach! https://yoteachapp.com

4. 4 HEALTH PROMOTION PRACTICE / Month XXXX
reflections (conducted in lieu of a final exam) revealed
that students desired opportunities for hands-on com-
munity engagement related to course concepts (e.g., vol-
unteering with efforts related to food insecurity).
Conclusions
The status quo as it pertains to health risk reduction
in young adults largely involves the use of generic inter-
ventions designed for adults and operates under the
assumption that individuals perceive themselves to be
at risk. Current initiatives are also limited with respect
to sustained interaction with peers. The animated case
study approach represents a new paradigm of chronic
disease prevention that engages young adults in self-care
and health promotion.
ORCID iD
Mary-Jon Ludy https://orcid.org/0000-0002-7887-255X
References
Höffler, T. N., Leutner, D. (2007). Instructional animation versus
static pictures: A meta-analysis. Learning and Instruction, 17, 722-
738. doi:10.1016/j.learninstruc.2007.09.013
Kaddoura, M. (2013). Think pair share: A teaching learning strategy
to enhance students’ critical thinking. Educational Research
Quarterly, 36, 3-24. Retrieved from https://eric.ed.gov/?id=EJ1
061947
LaRose, J. G., Leahey, T. M., Hill, J. O., Wing, R. R. (2013).
Differences in motivations and weight loss behaviors in young
adults and older adults in the National Weight Control Registry.
Obesity, 21, 449-453. doi:10.1002/oby.20053
Ludy, M. J., Crum, A. P., Young, C. A., Morgan, A. L., Tucker, R.
M. (2018). First-year university students who self-select into
health studies have more desirable health measures and behaviors
at baseline but experience similar changes compared to non-self-
selected students. Nutrients, 10, 362. doi:10.3390/nu10030362
Popil, I. (2011). Promotion of critical thinking by using case studies
as teaching method. Nurse Education Today, 31, 204-207.
doi:10.1016/j.nedt.2010.06.002
Wendt, S. J. (2005). Perception of future risk of breast cancer and
coronary heart disease in female undergraduates. Psychology,
Health Medicine, 10, 253-262. doi:10.1080/1354850041233133
4145
Xie, H., Liu, L., Wang, J., Joon, K. E., Parasuram, R., Gunasekaran,
J., Poh, C. L. (2016). The effectiveness of using non-traditional
teaching methods to prepare student health care professionals for
the delivery of mental state examination: A systematic review. JBI
Database of Systematic Reviews and Implementation Reports,
13(7), 177-212. doi:10.11124/jbisrir-2015-2263