Health preservation in children, adolescents, and young adults is one of the highest priorities of preventive medicine. The rising generation determines the country’s reproductive potential and prospects for social and economic development [1]. It is well known that some diseases and certain functional disorders occur as early as at school [2], however, university training places considerable burden on almost all organs and systems of the young body, thereby making these vulnerable during the development and exacerbation of chronic diseases [3,4].

The role of controllable risk factors related to tobacco smoking, alcohol abuse, malnutrition, and insufficient physical activity in the development of non-communicable diseases have been proven [5, 6]. The Russian and foreign students’ lifestyle is characterized by high prevalence of addictive behaviors, spending large amounts of time on social media, reduced night sleep duration, hypodynamia, violation of the basic principles of  healthy eating [1, 7–9].

Contemporary development of higher education institutions is aimed at maintaining health of individuals engaged in educational process [10]. Some regions of Russia have a good experience with implementation of projects on creating health preservation environment in higher education institutions [1, 11, 12], however, their contribution to health preservation in the studying youth remains small throughout the country [13–16].

Our aim was to develop and introduce the program for shaping healthy lifestyle and health improvement in student youth.

Workstreams within the framework of the program for shaping healthy lifestyle and health improvement in students

The program for shaping healthy lifestyle and health improvement in student youth was developed step by step. The first stage assumed analytical review of the research papers presenting the results of effective introduction of health preservation programs for university students [16]. At the second stage, behavioral health risk factors were assessed in students. It has been shown that the lack of the shaped health culture in young adults is associated with the development of morphofunctional disorders [17, 18]. The literature data and the results of our own studies provided the basis for the development of the complex of preventive measures as part of the educational process in the university.

The program for shaping healthy lifestyle and health improvement in individuals engaged in educational process for the years 2022–2027 (hereinafter, the Program) was developed and introduced at the Yaroslavl State Medical University. During implementation of the program the responsible executives are administration, structural units of the Yaroslavl State Medical University, and the Wellness Center of the Yaroslavl Central City Hospital. The Program brings together five workstreams (figure):

1. Optimization of training conditions and regime in accordance with the sanitary rules and regulations [19, 20]. This is a fundamental area that should provide the basis for other health preservation components of the educational process in the university.

2. Assessment of lifestyle and the related risk factors. This workstream is implemented in the university for the first time. To identify the priority behavioral health risk factors, university staff together with the Wellness Center of the Yaroslavl Central City Hospital assess lifestyle, estimate morbidity, physical development and functional capabilities of the young adults’ cardiorespiratory system (in accordance with the contract No. 225/27-1 on the research and technical cooperation). When studying at the Department of General Hygiene and Ecology, students of the general medicine and pediatric faculties are screened at the Wellness Center, where each student is both patient and supervisor of the Center.

3. The workstream “Health Culture Development” includes adjustment of the identified behavioral health risk factors in the form of individual counseling at the Wellness Center of the Yaroslavl Central City Hospital and the Department of General Hygiene and Ecology (at both individual and group levels); risk communication through engagement of students in working at the thematic and topical seminars and healthy lifestyle events.

4. Sport and wellness activities are included in the separate workstream of the Program due to high prevalence of irregular physical activity among young adults. The activities are supported by the “Zdorovye” Sports and Recreation Center of the Yaroslavl State Medical University. Organization of training and sectional classes, as well as systematic equipping of the university's sports facilities contribute to creation of favorable conditions for physical training and sports, while participation of teaching staff in the sports events and their orientation toward high physical activity contribute to shaping the health preserving behavioral pattern in students.

5. Health services management. The activities are implemented at the medical center of the Yaroslavl State Medical University. Currently, the center is responsible for vaccination and immunodiagnostics, counseling of the appealing students and medical check-ups; analysis of the medical commission conclusions of first-year students and admission of students to summer practical training. The leading measures of this workstream are improvement of methods to manage medical and preventive care and ensuring cooperation of the university with medical institutions.

Health preservation technologies included in the program for shaping healthy lifestyle and health improvement in students

The literature data confirm that risky behavior and health problems of students living in various regions have much in common [21–24]. Today there is no unified system for protection of university students’ health [13, 15], however, there are effective local projects [1, 10–12, 25] and prospects for the development of this field, as suggested by the results of the meeting of the Coordination Council of the Russian Academy of Sciences and Russian Academy of Education “Health and Education of Children, Adolescents, and Youth” [26].

From the point of view of approaches to health protection, the Program developed combines several health-saving technologies:

1. Medical and hygienic technologies include management of health services for individuals engaged in educational process, optimization of sanitary and hygienic conditions, and implementation of preventive measures.
2. Health preserving educational technologies. The workstream of the Program “Assessment of Lifestyle and the Related Risk Factors” is important for the development of the future specialists’ skills and thinking related to health preservation, which currently represents a pressing issue of higher education [27]. Visits to the Wellness Center allow junior students to learn about the activities of preventive medical institutions and the equipment for screening, as well as to combine the roles of patient and supervisor of the Wellness Center. After the check-up conducted within the framework of the “Hygiene” training course the students fill the “Health Card”, identify behavioral risk factors and select an individual preventive program, which is preceded by the questions about perception of the risk factors and current lifestyle. Teachers of the department assess the proposed preventive program. It should be noted that such interdepartmental cooperation increases primary and secondary attendance of the Wellness Center by young adults. Thus, integrative activity of the Wellness Center physicians and staff of the Department of General Hygiene and Ecology seems to be an important component of the student health culture development. The monograph [10] provides an example of a pedagogical system for developing a culture of students' health based on the integration of academic disciplines.
3. Sport and wellness technologies. Help of the “Zdorovye” Sports and Recreation Center of the Yaroslavl State Medical University expands development opportunities for individuals engaged in educational process. The university administration and teaching staff activity and adherence to healthy lifestyle contribute to formation of the health preserving behavioral pattern in students, so the health culture should be considered as joint activity of all individuals engaged in educational process. The health preserving education forms both health culture and general culture of a person [10].

CONCLUSION

The start-up program for shaping healthy lifestyle and health improvement in individuals engaged in educational process has been developed for students of the Yaroslavl State Medical University and introduced. The development prospects for the topic are improvement of the program in terms of interaction between its structural blocks and integration of academic disciplines, as well as creation of a digital information system for monitoring the health of young people and the system implementation in the educational process.