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Paul Terry	752	Editorial Belongingness, Well-Being and an Interview With Dr Pauline Dow The Supreme Court decision that race conscious admissions policies in universities are unconstitutional has created questions and concerns about the sustainability of diversity, equity and inclusion programs in many organizations and across sectors. This editorial provides hopeful examples of how belongingness is being embraced as a core value in many organizations. In an interview with education expert, Dr Pauline Dow, we discuss ways that the education sector creates trust and belongingness and explore best practices and leadership development methods that allow teachers to thrive. Lessons learned in the educator sector offer insights into how belongingness can be cultivated in other sectors, organizations and communities.
the Science of individual and collective Well-Being
Qi Chen, John Moore Lailea Noel, Kirk von Sternberg and Barbara Jones	757	Quantitative Research Sociodemographic Correlates of Low Health Literacy Skills Among Cancer Survivors: National Findings From BRFSS 2016 Purpose: This study aimed to explore associations of sociodemographic factors with difficulties in three health literacy (HL) skills and the severity of low HL skills. Design: Cross-sectional secondary data analysis. Subjects: Data came from 17,834 adults who responded to the HL module with a response rate of 47% in the 2016 Behavioral Risk Factor Surveillance System. Measures: Independent variables included sex, age, race/ethnicity, education, employment and income. Dependent variables are three HL skills: obtaining, understanding oral, and understanding written health information. Analysis: We conducted weighted Chi-square tests and multinominal logistic regressions. Results: Cancer survivors younger than 65 (aged 18-39: AOR = 4.46, P < .001; aged 40-64: AOR = 2.29, P < .001), Hispanic (AOR = 2.17, CI = 1.61-2.50, P < .01) had higher odds of difficulty obtaining health information. Female cancer survivors had lower odds of difficulty comprehending oral (AOR = .69, CI = .55-.87, P < .01) and written (AOR = .58, CI = .46-.74, P < .001) information. The relative risk ratio of having difficulties in three HL tasks was higher for those who were younger than 65 (aged 18-39: RRR = 10.18, CI = 2.41-4.3, P < .01; aged 40-64: RRR = 4.01, CI = 2.09-7.69, P < .001), Hispanic (RRR = 3.24, CI = 1.66-11.34, P < .01), unemployed (RRR = 6.1, CI = 2.88-12.76, P < .001), education levels lower than some college (some high school: RRR = 4.34, P < .01; high school: RRR = 2.62, P < .05) and household income under $25,000 (RRR = 6.99, CI = 2.8-17.5, P < .001). Conclusion: Intervention and communication materials need to be tailored for patients with different HL skills considering age, gender, socioeconomic status and cultural backgrounds.
Nasser Almutairi, Vinod Gopaldasani and Hassan Hosseinzadeh	767	Quantitative Research Relationship Between Patient Activation and Type 2 Diabetes Mellitus Self-management and Clinical Outcomes in Saudi Arabian Primary Care Setting Purpose: Type 2 diabetes mellitus (T2DM) self-management is a comprehensive approach that individuals with T2DM employ to manage and control their condition. Patients’ activation, “an individual’s knowledge, skill, and confidence for managing their health and health care”, has been used as a major driver of self-management. This study aimed to assess the relationship of patient activation with T2DM self-management and clinical outcomes. Design: A cross-sectional study. Subjects: Patients with type T2DM who age 18-years and older. Setting: The primary care centers in Saudi Arabia. Measures: Patient activation measure (PAM) and the Summary of Diabetes Self-Care Activities (SDSCA). Analysis: Descriptive statistic, T-test, One-way ANOVA test, Chi-square test, and linear and logistic regressions were performed. Results: A total of 398 patients, mostly male (54.9%) with a mean age of 53.2 (±10.7) years old participated in the study. The participants’ mean of Hemoglobin A1c (HbA1c) was 8.4% (±1.7%) and most of them (74.5%) had an uncontrolled HbA1c level (>7% %). The mean patient activation score was 55.9 (±13.5). 24.4% were at [PA1], 26.7% at [PA2], 37.4% at [PA3], and 11.5% at [PA4]. Patient activation level was positively associated with better glycemic control and self-management behaviors including diet, physical activity, blood glucose self-testing, foot care, and smoking (P < .05) but not with adherence to medication. Conclusions: Our findings reveal a positive association between patient activation level and enhanced glycemic control and self-management behaviors and suggest that patient activation-informed self-management interventions are more likely to yield promising health outcomes.
Karina L. Tavares and Cindy E. Tsotsoros	778	Quantitative Research The Relation Between Adverse Childhood Experiences and Health Behaviors in Adult Women Purpose: This study aims to identify whether adverse childhood experiences (ACEs) influence health lifestyles throughout adulthood and examine how ACEs influence dimensions of health lifestyles. Design: The data was collected cross-sectionally through an online questionnaire. Setting: Individuals were invited to participate in an online survey for a larger brain health study as a pre-screening measure. Subjects: Women in the Midwest between 18-25 and 65-85 who reported either no ACEs or 3 or more ACEs completed the survey, with 233 women answering all questionnaires. Measures: Demographic indicators, the 10-item ACEs questionnaire, and the Health Promoting Lifestyle Profile (HPLP-II). Analysis: Independent sample t-tests revealed significantly lower scores for ACEs group on the HPLP-II and the 6 subcategories (heath responsibility, interpersonal relationships, nutrition, physical activity, spiritual growth, and stress management). A structural equation model using the 3 ACE categories (abuse, neglect, and household dysfunction) and 6 health domains showed substantial differences in the variance captured for each health behavior. Results: Findings indicate that abuse predicts physical activity, stress management, and spiritual growth (β = _.21, _.23, _.20); neglect predicts interpersonal relationships and spiritual growth (β = _.17, _.18); and household dysfunction predicts health responsibility, nutrition, stress management, and interpersonal relations (β = _.20, _.22, _.10, _.17). Conclusion: The present investigation extends research in displaying that ACEs play a significant role in future health behaviors, with household dysfunction being the greatest predictor.
Beomyoung Cho, Yining, McKinley Chapman, Aaron Spaulding, and Sericea Stallings-Smith	787	Quantitative Research Changes in Obesity Prevalence Among U.S. Adults After the COVID-19 Pandemic by State and Territorial Stay-at-Home Order Level and Sociodemographic Characteristics Purpose: To examine changes in obesity prevalence among US adults after the COVID-19 pandemic by level of stay-at-home order and sociodemographic characteristics. Design: Quasi-experimental study using repeated cross-sectional data. Setting: Behavioral Risk Factor Surveillance System (BRFSS). Sample: Pooled data for US adults ages ≥26 years (n = 1,107,673) from BRFSS (2018-2021). Measures: States/territories were classified into three levels of stay-at-home order: none, advisory/only for persons at risk, or mandatory for all. Individual-level sociodemographic characteristics were self-reported. Analysis: The difference-in-differences method was conducted with weighted multiple logistic regression analysis to examine obesity (body mass index ≥30 kg/m2) prevalence by stay-at-home order level and sociodemographic characteristics before/after the COVID-19 pandemic (January 2018-February 2020 vs March 2020-February 2022). Results: After adjusting for a secular trend and multiple covariates, adults in states/territories with mandatory stay-at-home orders experienced a larger increase in obesity prevalence (adjusted odds ratio: 1.05; 95% confidence interval: 1.01, 1.11) than adults in states/territories with no stay-at-home order. Younger adults (vs ≥65 years) and individuals with <high school education (vs ≥4-year college) experienced larger increases in obesity prevalence. Conclusion: Increases in obesity prevalence were perpetuated 2 years after implementation of stay-at-home orders, indicating that longer-term health implications are co-occurring during the pandemic recovery period. Future research should focus on successful methods for staying active and healthy during social distancing and beyond.
Anjola Toyon, Zoran Bursac, Nicole Werner, Rebecca A. Krukowski	797	Quantitative Research Impact of Weight Concern on Post-Cessation Weight Management, Smoking Cessation, and Program Engagement Purpose: Weight concern is a barrier to smoking cessation. We examined the impact of weight concern on post-cessation weight gain, abstinence and program engagement. Design: Randomized-controlled trial. Setting: Telephone-based and group-based intervention sessions. Subjects: 305 participants were randomized and analyzed. Intervention: Participants were randomized to receive a self-guided intervention, a weight loss intervention, or a weight stability intervention prior to all receiving the same smoking cessation intervention. Measures: Level of weight concern on three measures, point-prevalence abstinence, weight change, and session attendance at 12 months. Analysis: Continuous and discrete outcomes were compared between weight-concerned and non-weight-concerned participants using two-sample t-tests and chi-square tests respectively. Results: There were no significant differences in weight change (range: +1.77, _1.91 kg) when comparing weight-concerned and non-weight-concerned participants. Point-prevalence abstinence ranged from 36% to 64%, with no differences by condition based on level of weight concern. There were no significant differences in session attendance by weight concern (Weight sessions: 50–70%, Smoking cessation sessions: 41–56%, Booster sessions: 28–45%). Weight concern, on all measures, significantly decreased between screening and 2 months (after the weight management intervention), for most of the comparisons made overall and by condition. Conclusion: It may not be necessary to screen for weight concerns in smoking cessation and/or post-cessation weight management programs, as the trial interventions were beneficial regardless of weight concern.
Emily Rose N. San Diego, Nathan T West, Latrice Crystal Pichon, Yu Jiang, Terrinieka Powell, Fedoria Rugless, Jonathan Lewis, Bettina Campbell, Lauren McCann, Sterling McNeals and Brook E Harmon	809	Quantitative Research Associations Between Sociodemographic Variables, Social Determinants of Health, and Diabetes: Findings From a Congregational Health Needs Assessment Purpose: To examine associations between sociodemographic variables, social determinants of health (SDOHs) and diabetes using health needs assessment data. Design: Cross-sectional study. Setting: Faith-based communities in the Mid-South U.S. Sample: Of the 378 churches, 92 participated in the study (24% response rate); N = 828 church leaders and members completed the survey. Measure: The Mid-South Congregational Health Survey assessed perceived health-related needs of congregations and the communities they serve. Analysis: Generalized linear mixed modeling examined the associations between sociodemographic variables (age, sex, race/ethnicity, educational level), SDOHs (affordable healthcare, healthy food, employment), and diabetes. Results: Individualswith less education had lower odds of reporting all SDOHs as health needs compared to individualswithmore education (ORrange = .59-.63). Men had lower odds of reporting diabetes as a health need or concern compared to women (OR = .70; 95% CI = .50, .97). African Americans had greater odds of reporting diabetes as a health need compared to individuals in the ‘Other’ race/ethnicity category (OR = 3.91; 95% CI = 2.20, 6.94). Individuals who reported affordable healthcare (OR = 2.54; 95% CI = 1.73, 3.72), healthy food (OR = 2.24; 95% CI = 1.55, 3.24), and employment (OR = 3.33; 95% CI = 2.29, 4.84) as health needs had greater odds of reporting diabetes as a health need compared to those who did not report these SDOHs as needs.
Lucas Bueno Gimenez, Vanessa Teixeira do Amaral, Gabriel Locato, Isabela Roque Marçal, Artur Junio Togneri Ferron, Emmanuel Gomes and Gomes Ciolac	820	Quantitative Research Gamification as a Tool for Promoting Physical Exercise and Healthy Eating Habits in Healthcare Worker Women: Effects on Cardiometabolic Health and Physical Fitness at Workplace Purpose: To evaluate the effectiveness of gamified versus nongamified health promotion interventions on cardiometabolic health and fitness parameters in healthcare worker women. Design: Randomized parallel group trial. Setting: A public outpatient health center in Brazil. Subjects: Women employees (included: n = 29; lost to follow-up: n = 1; analyzed: n = 28). Interventions: 8 weeks of gamified (n = 15) or nongamified (n = 13) interventions, consisting of health lectures, nutritional counseling, and supervised exercise training. The gamified group was divided into teams that received points based on completion of health goals/tasks. Measures: Anthropometric, cardiometabolic and physical fitness parameters. Analysis: Two-way ANOVA with repeated measures (group vs. time), and Bonferroni post hoc tests. Results: Body mass (-1.5 ± 1.5 kg), waist circumference (-1.6 ± 3.0 cm), HbA1C (-.2 ± .3%), triglycerides (-21.5 ± 48.2 mg/dl), systolic (-11.1 ± 7.9 mmHg) and diastolic (-7.1 ± 5.8 mmHg) blood pressure, as well as sit and reach (3.9 ± 3.0 cm) and sixminute walking (56 ± 37 m) performance improved (P < .05) only after the gamified intervention. Sit-to-stand performance improved after both the gamified (-1.18 ± 1.24 s) and nongamified (-1.49 ± 1.87 s) interventions. Conclusion: The gamified intervention was more effective than the nongamified intervention for improving cardiometabolic and physical fitness parameters, suggesting that gamification may be an effective tool for promoting health in healthcare worker women.
Ayse Dagistan Akgöz and Sebahat GÖZÜM	825	Quantitative Research Effects of the Omaha System- and HeartScore®-Based Impaired-Risk Perception Reduction Program on the Risk Perception of Individuals Aged 50–65 Years: A One-Group Pre-Test–Post-Test Study Purpose: This study evaluates the impact of interventions in the Omaha System and HeartScore®-based program to reduce impaired-risk perception. Design and setting: This study utilized a one-group pre-test–post-test design. Subjects: The program was conducted among participants aged over 50 years from different social settings. Intervention: The program had three parts: a briefing on HeartScore® recommendations, Omaha System interventions, and referral to a doctor. Measures: HeartScore® determined cardiovascular disease (CVD) risk, body mass index (BMI) was calculated from height and weight, and the International PA Questionnaire evaluated physical activity (PA) levels. Self-assessment was used to perceived CVD risk, BMI, and PA. Analysis: We used the Wilcoxon signed-rank test to compare the pre-test and post-test scores of the Omaha System, the problem rating scale (PRS) subscales and McNemar test to measure changes in CVD risk perception, BMI, and PA level. Results: 310 high-risk individuals out of 522 had impaired perception of their CVD risk. Only 201 responded to follow-up phone calls. Interventions based on HeartScore® and Omaha System improved CVD risk and PA perceptions (P < .001) but not BMI. The program significantly increased knowledge, status, and behavior scores (P < .001). After participating, 39% saw a cardiologist, and 57.2% saw a family physician within six months to reduce impaired risk perception. CVD risk perception increased to the actual level after the intervention, mostly in the group with low education level. Conclusions: The program using the Omaha System and HeartScore® can help middle-aged individuals better understand their risk of cardiovascular disease.
Thomas Erling Kottke Kottke, Jennifer Dinh, Maren Henderson, Laura J Jacobson, Rachael L Rivard, Jeanette Y Ziegenfuss, Katherine J Elllefson, Hikaru Peterson and Marna M Canterbury	839	Quantitative Research Don’t Say “Beans” When Promoting Plant Protein to Family Meal Planners Purpose: To identify “headlines” that would engage recipients to consider plant protein over red meat. Design: Mail and web survey. Setting: Urban Minnesota community. Subjects: 144 survey respondents from our health plan and community program distribution lists who live with at least 1 other person and eat meat. Intervention: We asked respondents how likely they would be to click on each of 24 headlines with a motivator (eating plant protein for health vs for environmental reasons) and a barrier (family preferences, knowledge about plant proteins, or cooking skills). 16 headlines contained the word “beans”. Measures: We created categorical variables for each headline construct: (1) motivator, (2) barrier, and (3) reference to beans. Using a mixed model with random effects, we compared, for each construct, respondents’ self-reported likelihood to click on a headline. Results: Health-related headlines performed significantly better than environmental headlines (P = .0019, 95% CI .01, .11). Family-oriented headlines performed slightly better than skills-oriented (P = .0927, 95% CI -.01, .11) and knowledge-oriented (P = .0960, 95% CI -.01, .11) headlines. Headlines containing the word “beans” performed significantly worse than those not containing “beans” (P < .0001, 95% CI -.22, -.12). Conclusions: The population represented by our survey respondents report being most likely to click on headlines that emphasize health and family. They report they are significantly less likely to click on headlines that promote beans.
Sherry Everett Jones, Nancy D Brener, Barbara Queen, Molly Hershey-Arista, William A Harris, Jonetta J Mpofu and J. Michael Underwood	843	Qualitative Research Reliability of the 2021 National Youth Risk Behavior Survey Questionnaire Purpose: The Youth Risk Behavior Survey (YRBS) monitors behaviors, experiences, and conditions affecting the health of high school students nationwide. This study examined the test-retest reliability of the 2021 national YRBS questionnaire. Design: Respondents completed a Time 1 and Time 2 paper-and-pencil questionnaire approximately 2 weeks apart during February to May 2022. Data were linked in such a way as to preserve anonymity. Setting: Convenience sample of high schools. Subjects: High school students (N = 588). Measures: Health risk behaviors and experiences assessed on the 2021 national YRBS questionnaire. Analysis: Time 1 and Time 2 responses were compared for each questionnaire item using the McNemar’s test. Then, Cohen’s kappa coefficients tested the agreement between Time 1 and Time 2 responses overall, and by sex, grade, and Black, White, and Hispanic race and ethnicity. Results: Among the 74 items analyzed, 96% had at least moderate reliability, and 73% had substantial or almost perfect reliability. The mean Cohen’s kappa was .68. McNemar’s test findings showed Time 1 and Time 2 data significantly differed (P < .01) for 9 items (12%). Conclusion: Reliable health behavior measures are important in the development of youth-focused public health programs and policies. Findings suggest the national YRBS questionnaire is a reliable instrument. Such findings lend support to relying on adolescent self-reported data when monitoring health behaviors using the YRBS.
Matthew Marquardt and Sheila Pontis	852	Qualitative Research A Mixed-Methods, Multimedia Pilot Study to Investigate Sleep Irregularity Determinants Among Undergraduate Students Purpose: To pilot a novel approach investigating the interplay of social and institutional determinants influencing university undergraduate student sleep patterns. Design: A two-part, three-phase mixed-methods approach. Setting: A mid-size US university conducted in spring and fall 2020. Participants: 191 undergraduate students (69 first-years, 43 second-years, 48 third-years, 31 fourth-years). Method: For Part A, participants texted their activities and emotions in real time, producing a data-rich, weeklong diary of comprehensive activity logs, emoticons, multimedia submissions, and juxtapositions of ideal vs real schedules. Semi-structured contextual interviews were also conducted. For Part B, a one-time survey examined Part A insights across all class years. These diverse datasets were triangulated using thematic, comparative, and content analyses through MAXQDA software and visual mapping methods. Results: Three preliminary themes were identified as encouraging an irregular sleep schedule: a prevailing academic ethos emphasizing busyness, time management challenges, and the rhythm of institutional schedules and deadlines. An overarching theme suggests that perceptions of peer sleep habits and academic prioritization above all else could be influential across factors. Conclusion: This pilot study indicates that sleep regularity among undergraduates is potentially shaped by individual choices combined with broader institutional paradigms. While it is limited by its exploratory nature, timing, and small sample size, the results highlight the promise of this methodology for more extensive studies and suggest that future interventions should emphasize systemic changes that prioritize sleep.
Nina Taylor, M. Margaret Dolcini, Joseph A Catania, Gary Harper, Audrey Cristobal and April Timmons	864	Qualitative Research Examining Sexual Health Organizational Networks in Urban African American Communities Using Social Network Theory Purpose: Collaboration among organizations offering sexual health and youth development services has the potential to provide youth with effective sexual health support. However, formally structured efforts (eg, coalition formation) may be impractical or unsuitable for low-income communities where resources are often already limited. Social network theories provide an alternative approach for building collaborative organizational networks. Approach: Research aims to evaluate the barriers and facilitators to collaboration in sexual health organizational networks. Setting: Organizations in low income, urban, communities in Chicago and San Francisco that serve African American adolescents. Participants: Providers (n = 22) from organizations that offer sexual health services and youth development services. Methods: Focus groups (n = 4) were conducted and analyzed utilizing a combination of coding strategies. Results: Barriers to collaboration included resource limitations and competition, differences in organizational roles and deliverables, and prejudice and stigma. Identifying common ground among organizations was found to be a facilitator to collaboration. Social network concepts in conjunction with study findings lead to the development of a practice model that hypothesizes a pathway for organizations to improve collaboration without formally structured efforts. Conclusion: Our findings offer ways to encourage collaboration among organizations that support youth sexual health in lowincome, urban, African American communities without relying on formal structures. Such collaborations may be critical for improving the provision of comprehensive sexual health support.
Alba Navas-Otero, Alicia Pineda-Nogueras, Araceli Ortiz-Rubio Ortiz-Rubio, Andrés Calvache-Mateo, Irene Torres-Sánchez, Marie Carmen Valenza and María Granados-Santiago	873	Literature Review Effects of Tai-Chi on Quality of Life in People With Neurodegenerative Diseases. A systematic Review of Randomised Clinical Trials Objective: This systematic review aimed to evaluate the effects of Tai Chi on the health-related quality of life (HRQoL) of people with neurodegenerative diseases. Data Source: This review followed the guidelines of the updated PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. A systematic search in five electronic databases (Medline via PubMed, Web of Science, Scopus, PEDro, and OTseeker) was performed. Study Inclusion and Exclusion Criteria: Randomized control trials (RCTs) examining Tai Chi interventions to improve HRQoL in patients with neurodegenerative diseases published through March 2023 were included. Data Extraction: Data were extracted from each study by two independent researchers into a data extraction form based on the Cochrane recommendations. Methodological quality and risk of bias were assessed. Data Synthesis: A meta-analysis was performed using Review Manager 5.3 software. Results: Of the 439 records that were screened, eight RCTs met the eligibility criteria. They assessed cognitive decline (n = 2) or Parkinson’s disease (n = 6). RCT comparison groups included active interventions or usual care. The duration of Tai Chi therapy ranged from 8 to 24 weeks. A sensitivity analysis using a fixed effect model indicated that Tai Chi therapy significantly increased HRQoL [P < 001, SMD (95% CI) = .41 [.21, .60], I2 = 4%]. Conclusion: Tai Chi can effectively improve the HRQoL of people with neurodegenerative diseases, but the heterogeneity across intervention was relatively high. Further studies are needed as research into the benefits of Tai Chi in neurodegenerative disease rehabilitation is still limited.
Knowing Well, Being Well
Mary Imboden	KWBW(883)	Belonging: An Essential Human and Organizational Need Belonging is a fundamental need that begins before birth, yet many people struggle to feel a sense of belonging. This is a public health issue, as lack of belonging is associated with poor physical and mental health. Research also shows that employee belonging is associated with business outcomes, including organizational commitment, job engagement, and job satisfaction. Therefore, employers should address belonging in the workplace and ensure their programs, policies, and practices all promote a culture of inclusion and belonging. This includes helping employees build the skills they need to belong, giving employees opportunities to belong, motivating employees to belong, and making sure all employees feel they belong through policies that promote inclusivity.
Wendy Birmingham,Julianne Holt-Lunstad, Raphael M. Herr and Abigail Barth, MPH.	KWBW(886)	Social Connections in the Workplace We spend nearly one-third of every day with our coworkers, thus our work relationships significantly contribute to our health and happiness. Positive interpersonal interactions lead to stronger sense of belonging and reduces workplace stress. Further, the organization benefits when their employees feel they belong, as workplace belonging and connection have been associated with performance outcomes. Organizations can address belonging in the workplace through implementing policies that promote inclusion, as well as programs and practices that provide opportunities to increase workplace connections and build trust within the organization. However, the key to the success of these initiatives is leadership support.
Kerry Evers and Madison Gilmore	KWBW(892)	Innovations Needed to Address Thwarted Belonging Among Employees with Marginalized Identities Belonging is an integral part of the human experience and a paramount human need and motivation. Experiences of belonging can serve to improve mental and physical health, as well as resilience. Whereas experiences of thwarted belonging are often antecedents to poor mental and physical health outcomes. A robust sense of belonging is not only vital to individual health and well-being, but to organizational or workplace health and well-being. Now more than ever, belonging is being viewed as fundamental to the way companies do business, as it is a key component of numerous positive organizational performance outcomes: reduced employee turnover, attrition, and absenteeism, and improvements in employee commitment, motivation, and pride. Yet, many organizations lack the policies, procedures, and programs necessary to make their employees—especially those who belong to marginalized or underrepresented groups—feel connected and included. In the workplace, LGBTQ+ individuals continue to face a dominant culture that is unwelcoming and discriminatory toward their identities. While interventions to promote workplace belonging among LGBTQ+ workers would address an important unmet public health need, existing company-sponsored wellness initiatives and solutions consist of a number of gaps that limit effectiveness and applicability to LGBTQ+ individuals navigating the transformed modern workplace.
Joni Troester and Kerry Evers	KWBW(895)	Understanding Belonging at Work: A Case Study of the University of Iowa’s Commitment to Employee Well-Being The University of Iowa recognizes sense of belonging in the workplace as an important aspect to employee health and well-being. In fact, it is considered a key focus area of their five-year strategic plan developed in 2022. This case study provides insight into how the University of Iowa’s Well-being and mental health Campus Collaborative is working to understand campus belonging, as well as develop initiatives and trainings to promote inclusion and belonging. Further, through collaboration with ProChange behavioral solutions, the University developed the IOWA-B assessment, a short question set to assess belonging at work. This case study discusses the development of the IOWA-B assessment, as well as how the results will be used to determine areas of priority to improve an employee’s sense of belonging in the workplace.