Consumer health education CHS 488 Lecture 2 By Dr. Ebtisam Fetohy-2012.

Consumer health educationConsumer health educationCHS 488CHS 488

Lecture 2Lecture 2

By Dr. Ebtisam Fetohy-2012By Dr. Ebtisam Fetohy-2012

Consumer HealthConsumer Health

I-Patient education, II-School health I-Patient education, II-School health education.education.

III- Occupational Health Education:III- Occupational Health Education: The growing cost of health care combined withThe growing cost of health care combined with The increase of preventable acute and chronic The increase of preventable acute and chronic

illnesses illnesses Drive the continuing need for comprehensive Drive the continuing need for comprehensive

worksite health promotion programs.worksite health promotion programs.

Occupational Health EducationOccupational Health Education

The worksite setting provides an The worksite setting provides an opportunity to implement: opportunity to implement:

educational programs;educational programs; policy and policy and environmental actions that support environmental actions that support

health, health, which benefit: which benefit: Managers, Managers, Employees, and, ultimately, Employees, and, ultimately, the community as a whole. the community as a whole.

Occupational Health EducationOccupational Health Education

Environmental hazards of Environmental hazards of many types exist in the many types exist in the workplace.workplace.

The U S public Health The U S public Health Service has estimated that Service has estimated that there may be as many as there may be as many as 390,000 new cases of 390,000 new cases of occupational disease each occupational disease each year and 100,000 deaths. year and 100,000 deaths.

III-Occupational Health EducationIII-Occupational Health Education

Categories of risks to the workers include:Categories of risks to the workers include:

1.Safety hazards or dangerous physical 1.Safety hazards or dangerous physical condition andcondition and

2.Health hazards such as high levels of 2.Health hazards such as high levels of toxic substances in the immediate toxic substances in the immediate environment.environment.


The number of carcinogens in the The number of carcinogens in the workplace is growing daily.workplace is growing daily.

Research has found that for many types of Research has found that for many types of cancer, there is a long latency period (20-cancer, there is a long latency period (20-30 year) following exposure before a 30 year) following exposure before a cancer can be detected.cancer can be detected.


For some cancers, the victim may have For some cancers, the victim may have been exposed only for:been exposed only for:

• a few weeks ora few weeks or• may have been exposed may have been exposed indirectly indirectly

through:through:

A- A- contamination of clothing at workcontamination of clothing at work or or

B- by living in a community where a high B- by living in a community where a high level of carcinogens is found in the level of carcinogens is found in the atmosphere.atmosphere.

III-Occupational Health EducationIII-Occupational Health EducationNeed for occupational health education:Need for occupational health education:

1. Extensive employee educational 1. Extensive employee educational programsprograms in order to foster the worker’s in order to foster the worker’s understanding of his/her rights and understanding of his/her rights and responsibilities under the federalresponsibilities under the federalاالتحاديةاالتحادية occupational safety and health laws.occupational safety and health laws.

Many large corporations have instituted:Many large corporations have instituted:• Annual health screening examinations& Annual health screening examinations& • Counseling programs for executivesCounseling programs for executives المدراء المدراء

التنفيذيين التنفيذيين and workers alike. and workers alike.


National Institute of Occupational Safety National Institute of Occupational Safety and Healthand Health (NIOSH) has proposed the (NIOSH) has proposed the establishment of establishment of regional centers to be regional centers to be primarily involved in:primarily involved in:

1-residency 1-residency المقيمينالمقيمين physicians training in physicians training in occupational medicine.occupational medicine.

2-curriculum development.2-curriculum development.

3-graduate training in related area such as 3-graduate training in related area such as industrial hygiene and safety engineering.industrial hygiene and safety engineering.

III-Occupational Health EducationIII-Occupational Health EducationA major problem is:A major problem is: The employees’ The employees’ fear of:fear of: • CancerCancer and and • Other Other industrial diseases coupledindustrial diseases coupled with their with their

equally equally • Strong fearStrong fear of plant closing (due to high of plant closing (due to high

toxicity levels) and the possible loss of their toxicity levels) and the possible loss of their jobs.jobs.

Many workers come to terms with potential Many workers come to terms with potential dangers by dangers by denying the possibilitydenying the possibility of c of cancancer er in the worksite.in the worksite.


A concerted A concerted مشتركةمشتركةefforts byefforts by:: • • Management------ Management------ ادارةادارة • • Unions------ Unions------ نقابية نقابية اتحادات اتحادات • • Health professionalsHealth professionals • • The workers themselves.The workers themselves. This concerted effort is neededThis concerted effort is needed for for allall to come to come

to to grips grips with the with the problemsproblems of of occupational occupational diseasesdiseases..

The task force report concluded:The task force report concluded: “ “ The same four factors that hamper The same four factors that hamper يعوقيعوقother other

forms of Health Education are present, namely:forms of Health Education are present, namely:

III-Occupational Health EducationIII-Occupational Health Education Barriers to occupational health educationBarriers to occupational health education::

11 - -individual ignoranceindividual ignorance..2- public apathy 2- public apathy الالمباالةالالمباالة..

33 - -commercial pressure andcommercial pressure and44 - -lack of strong positive leadership on the lack of strong positive leadership on the

part of eitherpart of either::A.A. The government or The government or B.B. The health professions,The health professions,

All negatively affect occupational health All negatively affect occupational health programs.programs.

Physical activity and fitnessPhysical activity and fitness Nutrition and weight controlNutrition and weight control Stress reductionStress reduction Worker safety and healthWorker safety and health Blood pressure and/or cholesterol Blood pressure and/or cholesterol

education and controleducation and control Alcohol, smoking and drugsAlcohol, smoking and drugs

Reduce medical care costsReduce medical care costs Enhance productivityEnhance productivity Enhance the imageEnhance the imageصورةصورة of the of the

companycompany

Worksite Health Promotion ~Worksite Health Promotion ~ Practitioners PerspectivePractitioners Perspective

Relatively new phenomenon (mid-1970s)…Relatively new phenomenon (mid-1970s)…

On-site programs…On-site programs…

Programs vary widely in content and focus…Programs vary widely in content and focus…

Some programs offer during work hours, some before Some programs offer during work hours, some before and after work hours…and after work hours…

Some totally funded, some employee-employer Some totally funded, some employee-employer funded…funded…

Rationale:Rationale: (1)(1) Employee spends 1/3 of his life on the Employee spends 1/3 of his life on the job. We have a captive job. We have a captive اسيراسير audience. audience.

(2)(2) Healthy employees save the employer money. Healthy employees save the employer money.

(3) (3) Morale and turnover Morale and turnover مبيعاتمبيعات are positively impacted.are positively impacted.

Sites of occupational educationSites of occupational education

Private clubs (Gold’s Gym)Private clubs (Gold’s Gym)

Parks Parks متنزهاتمتنزهاتand Recreation Depts.and Recreation Depts.

College’s/UniversitiesCollege’s/Universities

HospitalsHospitals

Condo Condo خاصة خاصة شقة Apartment complexes/Apartment complexes/ شقة

HotelsHotels

Resorts Resorts مصايفمصايف and Cruise and Cruise جوالت جوالتlineslinesبحريةبحرية

Advantages of employment in Worksite H.PAdvantages of employment in Worksite H.P..

Opportunity for prevention emphasisOpportunity for prevention emphasis

Access to individuals who might not Access to individuals who might not participate in community programsparticipate in community programs

Diverse groups of people (upper Diverse groups of people (upper management to blue collar workers)management to blue collar workers)

Generally a high degree of job satisfactionGenerally a high degree of job satisfaction

Pay and benefits generally goodPay and benefits generally good

Access to fitness facilities for personal useAccess to fitness facilities for personal use

Disadvantages in Worksite settingDisadvantages in Worksite setting

Long and irregular hours (e.g., shift work)Long and irregular hours (e.g., shift work)

Not much room for advancementNot much room for advancementتقدمتقدم

Program is low on the corporate priority listProgram is low on the corporate priority list

Subcontracting Subcontracting ثانوي ثانوي تعاقد يسيطريسيطرmay take overmay take over تعاقد

Strong pressure to be a role modelStrong pressure to be a role model

Why Community Health Education?Why Community Health Education? Community-Based Health Education: Community-Based Health Education: A A

key to prevention and early detectionkey to prevention and early detection

Because Over the last century, the Because Over the last century, the leading causes of death have shifted leading causes of death have shifted from infectious diseases to chronic from infectious diseases to chronic behavioral oriented types of diseases. behavioral oriented types of diseases.

Community/Public Health Education:Community/Public Health Education:Joint Committee on Health Education…Joint Committee on Health Education…

……the application of a variety of methods that result in the application of a variety of methods that result in the education and mobilization of community members the education and mobilization of community members in actions for resolving health issues and problems in actions for resolving health issues and problems which affect the community. which affect the community.

These methods includeThese methods include, but are not limited to, , but are not limited to, group group processprocess, mass media, communication, , mass media, communication, community community organizationorganization, organization development, , organization development, strategic strategic planningplanning, skills training, skills training, legislation, legislation, policy making, and , policy making, and advocacyadvocacy..

Community Health ProgramsCommunity Health Programs

Basic premiseBasic premise:: The The health of a community is health of a community is the sum total of the health the sum total of the health of the individuals of the individuals comprising that comprising that community..community..

The present day leading causes of death The present day leading causes of death result from lifestyle choices or behaviors: result from lifestyle choices or behaviors:

• Injury, Injury, • Violence, and Violence, and • Other factors in the environment; and Other factors in the environment; and

unavailability or inaccessibility of quality unavailability or inaccessibility of quality health programs and services.health programs and services.

While health promotion in schools, health care centers, and worksites provides targeted interventions for specific population groups, community-based programs can reach the entire population.

IV-Community health educationIV-Community health education It is the program designed to help people It is the program designed to help people

developdevelop::1.1. Necessary attitudes,Necessary attitudes,2.2. Knowledge andKnowledge and3.3. Practices for optimal state of health for Practices for optimal state of health for

themselvesthemselves, their families and , their families and communitiescommunities.. They are offered through:They are offered through:

• Federal, state and local public agencies,Federal, state and local public agencies,• Charitable Charitable خيريةخيريةorganization,organization,• Voluntary Voluntary طوعيةطوعيةagencies andagencies and• Hospitals.Hospitals.

IV-Community health educationIV-Community health education Many hospitals are involved in community Many hospitals are involved in community

programs offering education on specific programs offering education on specific diseases and general health information. diseases and general health information. For For e.g., a typical hospital with an active e.g., a typical hospital with an active community health education program may community health education program may offer:offer:

1. diabetes;1. diabetes;

2. ostomy and2. ostomy and

3. cardiac as well as smoking clinics;3. cardiac as well as smoking clinics;

4. parental 4. parental أبويةأبوية and parenting and parenting أبوةأبوة classes; classes;

IV-Community health education, contIV-Community health education, cont 5. obesity programs5. obesity programs 6. a cardiopulmonary resuscitation course;6. a cardiopulmonary resuscitation course; 7. industrial health education;7. industrial health education; 8. drug education and8. drug education and 9. program concerning venereal diseases.9. program concerning venereal diseases. The objectives should be:The objectives should be: 1.Identification of the needs and1.Identification of the needs and 2.Determination of specific health risk factors that 2.Determination of specific health risk factors that

exist in the community.exist in the community. Risk factors vary depending on Risk factors vary depending on thethe : :• • racial;racial;• • socioeconomic andsocioeconomic and• • occupational structure of the community.occupational structure of the community.

IV-Community health educationIV-Community health education

Once the community’s needs have been Once the community’s needs have been identified, programs can be designed to identified, programs can be designed to meet them.meet them.

The major problem of Community HE are:The major problem of Community HE are:

• • Insufficient program funding andInsufficient program funding and

• • Inability of many agencies to involve Inability of many agencies to involve consumers in their programs.consumers in their programs.

IV-Community health educationIV-Community health educationIt is essential that community programs be It is essential that community programs be

designed with the consumer in mind so designed with the consumer in mind so that:that:

1. Language difference;1. Language difference;2. Economic conditions and2. Economic conditions and3. Consumers’ 3. Consumers’ free timefree time to attend such to attend such

programs are taken into consideration. programs are taken into consideration. Where the Where the majoritymajority of of both menboth men and and womenwomen hold jobshold jobs, programs should be arranged at , programs should be arranged at appropriate hoursappropriate hours..

4. Another major problem of community 4. Another major problem of community health programs is the lack of compliance. health programs is the lack of compliance.

IV-Community health educationIV-Community health education

Many individual consumers do not follow Many individual consumers do not follow up on risk factors identified through up on risk factors identified through community screening programs.community screening programs.

Even after thorough Even after thorough شاملشاملprogram of program of telephone calls and letters, telephone calls and letters, the compliance the compliance rate is frequently very low.rate is frequently very low.

Included in the community setting are:Included in the community setting are: public facilities; public facilities; local government agencies; and local government agencies; and social service, social service, faithfaith, and civic , and civic مدنيمدني

organizations that provide channels to organizations that provide channels to reach people where they reach people where they livelive, work, and , work, and playplay. .

They can be strong advocates for They can be strong advocates for educationaleducational, policy, and , policy, and environmentalenvironmental changes throughout the community. changes throughout the community.

Places of worship Places of worship العبادةالعبادةmay be a may be a particularly important setting for health particularly important setting for health promotion initiatives, and they may promotion initiatives, and they may effectively reach some underserved effectively reach some underserved populations.populations.

A Day in the Life of a Community A Day in the Life of a Community Health EducatorHealth Educator

Advantages/Disadvantages of Working in Advantages/Disadvantages of Working in Community/Public Health Education:Community/Public Health Education:ADVANTAGESADVANTAGES::

1.1. Highly varied and dynamic job Highly varied and dynamic job responsibilitiesresponsibilities

2.2. Strong prevention orientationStrong prevention orientationتوجيهتوجيه 3.3. High community profileHigh community profile4.4. Work with multiple groups (ethnicities)Work with multiple groups (ethnicities)5.5. High degree of self-satisfactionHigh degree of self-satisfaction

DisadvantagesDisadvantages of working in of working in Community/Public Health EducationCommunity/Public Health Education

1.1. Low pay, especially in the voluntary health Low pay, especially in the voluntary health agenciesagencies

2.2. If employment depends upon soft If employment depends upon soft السهلالسهل money, job security is tenuous…money, job security is tenuous…ضعيفضعيف

3.3. Volunteers can be unreliable and Volunteers can be unreliable and irresponsible…irresponsible…

4.4. Lack of funding is always a problem.Lack of funding is always a problem.

V-National health and health V-National health and health related agency programsrelated agency programs

These programs differ from those already These programs differ from those already

mentioned because they are mentioned because they are sponsoredsponsored by by

voluntary nonprofit agenciesvoluntary nonprofit agencies as well as as well as

profit making agencies.profit making agencies.

Two sources of employmentTwo sources of employment::

1.1. Voluntary Health AgenciesVoluntary Health Agencies: Address health : Address health

needs not met by government needs not met by government

agencies….American Cancer Society, agencies….American Cancer Society,

American Heart Association, American Lung American Heart Association, American Lung

Association.Association.

2.2. Public Health AgenciesPublic Health Agencies: Government health : Government health

agencies (tax supported)…Public Health agencies (tax supported)…Public Health

Departments.Departments.

V-National health and health related V-National health and health related agency programsagency programs

For e.g., because of its extensive public For e.g., because of its extensive public information program, information program, the American Cancer the American Cancer Society’s “seven danger signals” have widely Society’s “seven danger signals” have widely known by the public:known by the public:

1.1. Unusual bleeding/dischargeUnusual bleeding/discharge::• Blood in urine or stoolBlood in urine or stool• Discharge from any part of the body, for e.g., Discharge from any part of the body, for e.g.,

nipple, penis, etc.nipple, penis, etc.


2. A sore which does not heel: sores that:2. A sore which does not heel: sores that:• Don’t seem to be getting better over timeDon’t seem to be getting better over time• Are getting biggerAre getting bigger• Getting more painfulGetting more painful• Are starting to bleed.Are starting to bleed.

3.Change in bowel or bladder habits:3.Change in bowel or bladder habits:• Change in the color, consistency,Change in the color, consistency, size, or size, or

shape, of stool (diarrhea, constipation)shape, of stool (diarrhea, constipation)• Blood present in urine or stool.Blood present in urine or stool.


44. . Lump in breast or other part of the body:Lump in breast or other part of the body:• Any lump found in the breast when doing a Any lump found in the breast when doing a

self examination.self examination.• Any lump in scrotum when doing a self Any lump in scrotum when doing a self

examinationexamination• Other lumps found on the body. Other lumps found on the body.


5. 5. Nagging Nagging مزعجةمزعجةcough:cough:• Change in voice and hoarsenessChange in voice and hoarseness• Cough that doesn’t go awayCough that doesn’t go away• Sputum with bloodSputum with blood

6.Obvious change in moles 6.Obvious change in moles شاماتشامات: use the : use the ABCD roles:ABCD roles:

• Asymmetry: Does the mole look the same Asymmetry: Does the mole look the same in all parts or are there differences?in all parts or are there differences?

• Border: are the borders sharp or Border: are the borders sharp or raggedraggedخشنخشن ??

• Color: what are the colors seen in the Color: what are the colors seen in the mole?mole?

• Diameter: is the mole bigger than a pencil Diameter: is the mole bigger than a pencil eraser (6 mm)? eraser (6 mm)?


7.Difficulty in swallowing:7.Difficulty in swallowing:• Feeling of pressure in throat or chest which makes Feeling of pressure in throat or chest which makes

swallowing uncomfortableswallowing uncomfortable• Feeling of full without food or with small amount of Feeling of full without food or with small amount of

food.food. Such groups as:Such groups as:• • weight watchers;weight watchers;• • Alcoholics anonymous; andAlcoholics anonymous; and• • Smoke Enders, are only a few of the numerous Smoke Enders, are only a few of the numerous

organizations that have a health message to impart.organizations that have a health message to impart. However, general health education is not their major However, general health education is not their major

objectiveobjective..


AdvantageAdvantage::

• • They manage to affect the public’s lifestyle They manage to affect the public’s lifestyle in areas where professional health in areas where professional health education has failed.education has failed.

• • These health and health related agencies These health and health related agencies have an impact upon society in many have an impact upon society in many areas of consumer health education.areas of consumer health education.


Frequently, one’s experience with a disease Frequently, one’s experience with a disease or condition gives one a much better or condition gives one a much better perspective for, related to it and teaching perspective for, related to it and teaching others who are similarly afflicted.others who are similarly afflicted.

For e.g., the Reach for Recovery program of For e.g., the Reach for Recovery program of the American Cancer Society utilizes the American Cancer Society utilizes volunteers who have undergone mastectomy volunteers who have undergone mastectomy operations in the rehabilitation of recent operations in the rehabilitation of recent mastectomy patients( self- help group).mastectomy patients( self- help group).

VI-The MediaVI-The Media People get information about health from media People get information about health from media

especially Television.especially Television. According to Harris Poll commissioned by the According to Harris Poll commissioned by the Blue Cross Association, 29% of the people Blue Cross Association, 29% of the people surveyed reported that they received most of surveyed reported that they received most of health and medical information from TV health and medical information from TV advertising.advertising. Only doctors exceed the media in providing Only doctors exceed the media in providing health information.health information. This might be positive indicator. If the This might be positive indicator. If the information received from the media were information received from the media were accurate.accurate.

VI-The MediaVI-The Media Disadvantages:Disadvantages: However, investigation have revealed that much However, investigation have revealed that much

of the information regarding health was:of the information regarding health was: • • Inaccurate;Inaccurate; • • Misleading or both.Misleading or both. Advantages:Advantages:

Television and the media in general, offer an Television and the media in general, offer an excellent vehicle for health information which is excellent vehicle for health information which is both:both:

• Accurate andAccurate and• Relevant.Relevant.

VI-The MediaVI-The Media Most people have seen and assimilated Most people have seen and assimilated تستوعبتستوعب

information from: information from: • health documentaries health documentaries الوثائقياتالوثائقيات, , • public broadcasting, or public broadcasting, or • advertising provided by health agencies.advertising provided by health agencies.

Health message advertising is most effective in areas Health message advertising is most effective in areas of:of:

• SmokingSmoking• Venereal diseases (VD);Venereal diseases (VD);• Hypertension andHypertension and• Sickle- cell anemia.Sickle- cell anemia.

VI-The MediaVI-The Media

It has been estimated that daily Radio It has been estimated that daily Radio audience exceeds116 million adults and audience exceeds116 million adults and

T.V audience exceeds 64 million adults.T.V audience exceeds 64 million adults.

Given that potential combined with Given that potential combined with readership of printed media. One can readership of printed media. One can easily see the advantages of utilizing mass easily see the advantages of utilizing mass media for HE purposes. media for HE purposes.

VI-The MediaVI-The Media Needs :Needs :There is a definite need for the media to:There is a definite need for the media to: Regulate the preparation of appropriate Regulate the preparation of appropriate

broadcast materials and a need for: broadcast materials and a need for: Clearly defined accountability Clearly defined accountability

;to the public;to the publicمسؤوليةمسؤولية There is also need for health educators There is also need for health educators

and broadcasters to cooperate in the and broadcasters to cooperate in the development of health education development of health education Programming.Programming.

Landing Landing توجيهتوجيهthe First Jobthe First Job

Summer employment in health ed Summer employment in health ed

settingssettings

Volunteer work in health ed Volunteer work in health ed

settingssettings

Develop a professional portfolioDevelop a professional portfolio

Certifications (CHES)Certifications (CHES)

Faculty recommendationsFaculty recommendations

Professional organizationsProfessional organizations

GRADUATE SCHOOLGRADUATE SCHOOL

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Consumer health education CHS 488 Lecture 2 By Dr. Ebtisam Fetohy-2012.

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