Health education

Dr. Dalia Abdallah El-ShafeiLecturer, Community Medicine Department, Zagazig University

Definition Planned opportunity for people to learn about health & make changes in their behavior.[It includes]

Goals of health education

Social change goal

Complex goal of making Healthy choices Easier choices

Changing social, physical environment so that people are encouraged to adopt health behaviors.

Effect of physical exercise on healthConscious exercise is healthy.Knowledge strength my body & heart.Self awareness feel unfit.Attitude change believed exercise is valuableDecision making will join sport club.Behavior change go to club, walk to work ext..Social change sport facilities available

Effect of physical exercise on health

1 & 2 Know 3 & 4 Feel 5 Know & Feel 6 Do 7 Healthy choices are easier

Concepts of HE

Dimensions of HEWhole person [physical, mental, social].Life long process.All points of health & illness [1ry, 2ry & 3ry].Directed towards [persons, families, group & community.]Help in making health choices easier choicesInvolve [formal & informal teaching].Wide range of goals [information, attitude change, behavior change & social change].

Health Education Program

Link between knowledge attitude & behaviorSocial class.

Education.Age.

sex.Beliefs - Attitudes - Intention - Behavior.Peer.

Pressure.Culture.

Norms.Knowledge experienceExpectation of others

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Where we are ????????????Situation analysis

2. Identify needs & priorities:It will determine the objectives & outcome

Health Education NeedsFelt or perceived needsWhat people want but not necessary expressedNormative needs Level of services which experts set versus desirable standard for individual or whole community Comparative needs Comparing service provision across communities or groups Expressed needs Actual number of people using or demanding a service

3- Decides Goals & Objectives

Goal = Broad AimGoals will be reached by the end of the program.

Objectives should be SMART:

Planning of the program

Guidelines to select the HE method

2- Plan evaluation methods

II. implementation

Relationship between educator & client:

Factors related to educator

Situation clients adopt ve feelingsIgnoring capabilities & strengths of the client.Ignoring client efforts & achievements.Raising the sense of guilt & anxiety.Bad experience of the client.Lack of trust.The educator is a threat criticism.Clients believe he knows everything.Client is intimidated. Factors related to client[Feelings that lead to either accepting or refusing the message]

Situation clients adopt +ve feelings

The educator praises effort of the client.The educator doe not imply the clients behavior as morally bad.Minimize feelings of helplessness.

The communication style:

Permissive or democratic style+ve aspects:Clients are reactive.Allowed to express their feelings.They take responsibility.- ve aspects:Discussed subjects limited to client's likes.Uncomfortable issues are not considered.

Authoritarian or paternalistic styleStrict obedience+ve aspects:Clear guidelines.Easily resolve the problem.- ve aspects:- ve attitude of the client

Barriers:

Social & Cultural gab between educator & client.

Different Social class. Religious beliefs. Values Gender.

Limited receptiveness of client.Illness, Tiredness, pain, Emotional distraction or being too busy.

Limited understanding & memory.Limited intelligence.Poor memory.Use of medical jargon.Insufficient emphasis on education by the health professionalEducator is too confident so acts in reluctant way.Educator is too busy and didnt prepare the materials.Educator is in a hurry & not enthusiastic.Educator doesnt believe in the value of HE.

The delivered messages are contradictory.Different specialties say different things.Family, friends & neighbors contradict the HP.Expert keep changing their minds.

III. Monitoring & EvaluationSystematic & logical method for making decisions to improve HE program

1- Structure Evaluation of components:Place.Aids.Materials.

- Written feedback from the learner [evaluation sheet].

- Verbal forms or non verbal as [facial expressions or enthusiasm or participation level]

2. ProcessIt examine the dynamic components of the educational program

Involves evaluation of the sustainability of the process used to meet the goals & objectives

Assess the dynamics of interaction between educators & learners

Changes in Health consciousness:The level of interest of consumers [no of clients]The degree the media covered the HE activities.Data collected from questionnaires.

Changes in knowledge:Interviews & discussion between educator &clientsObservation of use of knowledge by the clients.The results of the pre & post tests.

Changes in self awareness & attitudes:Observing the changes in what the clients do during HE.Ask the clients to rate their attitudes.

Changes in decision making:What the client proposes to do whether verbally or in writing.

Behavioral changes records:Changes in no of clients attending the service.Changes of smoking behavior noticed from questionnaire.

Social changes:Policy changes: [increase areas where smoking is forbidden in public areas].Changes in legislations: [obligatory use of seat belts].Increase in facilities that promote healthy behavior [sports clubs].

Community participation

Research Subjects

ResearchersCommunities

Duke Center for Community Research http://www.dtmi.duke.edu/dccr/community-linked-research/43Health researchers have been working in communities for decades. Researchers have traditionally turned to communities to recruit research subjects or to conduct a study on a community. Communities, particularly minority and low-income communities, felt that they seldom received benefits from this type of research. They expressed anger and frustration that researchers completed their research and left, without sharing their findings or creating a mechanism to continue successful programs. Research topics were selected by researchers without determining whether those topics addressed the perceived needs or concerns of the community, adding to the sense that research was not intended to help communities address problems, but rather was based entirely on the researchers area of expertise.

Lasker RD, Weiss ES. 2003

Research Participants

ResearchersCommunities

Being the subject of research is different from being a participant in research

Duke Center for Community Research http://www.dtmi.duke.edu/dccr/community-linked-research/44Being the subject of research is different from being a participant in research. With a community-engaged approach communities are seen as partners and collaborators and community members are viewed as research participants, not as research subjects. Community members who have not worked on the planning of the research or been involved in any way, but who volunteer to enroll in the research, are still called participants rather than subjects. In medical research subject has been the term used for people enrolled in a study, and this term is institutionalized within many Institutional Review Boards. However, with a community-engaged approach the term participant is standard. One reason for using the term participant is that many communities, especially minority communities, do not like the term subject. Research shows that this word makes people think of being powerless or like guinea pigs in an experiment. Since researchers are forming partnerships with community organizations and working to build trust in the community, it is important to use terms that are appropriate to the setting.Research terminology is changing and in current regulations and medical journals biomedical research subjects are now called participants. The New England Journal of Medicine, the American Journal of Public Health and the International Committee of Medical Journal Editors use participant. Carlson, ED. 2004; Corbie-Smith, G. 1999; Freimuth, VS. et al. 2001; Lasker RD, Weiss ES. 2003; Minkler M. 2005

Definition In short people share the same experiences and belong to the same culture.

Role of community in inducing changeIt ensures the program represents the perceptions, needs, culture, beliefs & priorities of the community.

Community participation ensures community ownership & motivation.

Make people feel they have a role & are able to make their own decisions thus become empowered and more able to solve problems.

Ways of developing Community ParticipationBe open about policies & plans.Plan for the community expressed needs.De- centralize planning.Develop joint forum & network.Provide support, advice & training for community groups.Help them with fund & resources.Support advocacy project