Quality Health Education

1. Quality Health Education Responding to Client Needs

2. Presentation Objectives • Identify the leading causes of death and their risk factors • Describe the role of health education in relation to self-actualization achievement • Discuss strategies for ensuring the delivery of quality health education • Describe CSULA Student Health Center health education services

3. The Link between Behavior and Health

4. Leading Causes ofDeath & Their Risk Factors • Leading causes of death (United States, 2005)* • Heart Disease: 652,091 • Cancer: 559,312 • Stroke (cerebrovascular diseases): 143,579 • Chronic lower respiratory diseases: 130,933 • Accidents (unintentional injuries): 117,809 • Diabetes: 75,119 • Alzheimer’s disease: 71,599 • Influenza/pneumonia: 63,001 • Nephritis, etc.: 43,901 • Septicemia: 34,136 • Risk factors • Behaviors, attitudes & beliefs, health conditions, socioeconomic status, environmental influences and other factors that may negatively impact health status • Lifestyle (i.e., behavior) is the primary risk factor for the 20 top killers • Inactivity, poor diet, behaviors that cause accidents, unsafe sex, etc. • Leading Causes of Death in Children and Adolescents • Accidents • Heart disease • Cancer • Homicide • Birth defects • Suicide *National Center for Health Statistics (CDC)

5. Personal Health

6. Health and Wellness • Health • Medical model • Absence of death, disease, discomfort, disability, and dissatisfaction • Environmental model • Health is influenced by environmental factors including socioeconomic status (SES) and physical environment • Holistic model • Health is a dynamic interaction between an individual’s physical, emotional, spiritual, intellectual, social, and environmental wellbeing

7. Personal Health • Three central ideas of personal health • Good health requires taking responsibility for one’s health and making “deliberate” choices and taking deliberate action to be healthy • Self-efficacy • The conviction that a person can successfully change his or her behavior in relation to a desired result • Self-efficacy influences • Target behaviors and situations; Amount of effort given; Length of time devoted to change efforts; Perceptions • Good health involves an interaction of the various dimensions of wellness • Commitment to good health is a necessary for having a happy, fulfilling, and productive life Health Framework for California Public Schools: Kindergarten Through Grade Twelve (Health Framework)

8. Health Literacy • Defined as.. • “The capacity of an individual to obtain, interpret, and understand basic health information and services and the competence to use such information and services in ways that are health-enhancing.” • Key components • Acceptance of personal responsibility for lifelong health • Respect for and promotion of the health of others • An understanding of the process of growth and development • Informed use of health-related information, products, and services Health Framework

9. Health Literacy • Health literate individuals • Accept personal responsibility for lifelong health • Committed to healthy living; acknowledge control; apply health knowledge • Respect and promote the health of others • Understand and acknowledge: the impact of their behavior on others; influence of individuals on the environment; how the environment can affect health • Understand the process of growth and development • Understand and acknowledge common and unique aspects of growth and development; respect others • Use health-related information, products, and services in an informed manner • Wise healthcare consumers Health Framework

10. Maslow’s Hierarchy of Needs • Self-actualization • Fulfillment, striving to become everything you are capable of becoming • Wellness lifestyle, health literate… • Esteem • Self-esteem, achievement, respect • Self-efficacy… • Belongingness • Relationships, family, friends • Respect, honesty, dependability… • Safety • Protection, stability, trust • Safer sex, violence-free relationships… • Physiological • Air, water, shelter, food, sleep • Knowledge, self-care… • In order to find fulfillment, basic needs must first be met • Expanded views • Aesthetic needs • Spirituality, beauty, balance, form • Cognitive needs • Knowledge, meaning, self-awareness • Transcendentalism • Helping others to reach self-actualization • Role of health educators J. Gaspar, Kolander et. al.

11. Ensuring Quality in Health Education

12. Education and Credentialing • Health education settings • Healthcare and social assistance settings (50%) • State and local government (20%) • Education • Entry level minimum requirement is a bachelor’s degree in health education or a related area • Master’s degree is preferred or required depending on setting • Master of Public Health (MPH) • Master of Science, Public Health (MSPH) • Master of Arts (MA) or Master of Science (MS) in a related area • Doctoral degree required for administrative and tenure track teaching positions • Doctor of Public Health (DrPH) • Doctor of Philosophy (Ph.D.) • Credentialing and certifications • Required or preferred depending on setting • Certified Health Education Specialist • National Commission of Health Education Credentialing, Inc. • Related to job function Bureau of Labor Statistics (U.S. Department of Labor)

13. Accreditation • Health education standards • Services are appropriate for the needs of the population served and includes mechanisms for conducting complete needs assessments • Health promotion and education services are provided by qualified personnel with access to appropriate resources • Health education programs include clearly defined goals and objectives and evaluation methods • Organization has adequate resources for the delivery of health education services • Marketing of health education programs accurately reflects services Accreditation Association for Ambulatory Health Care, Inc. (AAAHC)

14. Accreditation • Health education standards • Policies and procedures exist to assess satisfaction with health education services • Health education services are documented in the medical record, as appropriate • Health education programs should be comprehensive with a holistic view • Alcohol and other drugs; healthy eating; physical fitness; sexuality; healthy relationships; violence prevention; stress management • Health education should be included in quality improvement activities AAAHC

15. Health Education Programming • Health educators must be able to apply key models and theories to their work National Cancer Institute

16. Health Education Programming National Cancer Institute

17. (Inter-)Personal Theories • Health Belief Model • Perceptions directly influence health behaviors • Seriousness of issues • Susceptibility to condition • Benefits of health promoting change • Barriers to health promoting change • Cues to action stimulate change • Health event, discussion with friends, commercial • Social Cognitive Theory • Behavior is influenced by expectations and incentives • Expectations • How events are connected, consequences of behavior, ability to change (self-efficacy) • Incentives for change • Perceived outcome value • Theory of Reasoned Action • Behavior is influenced by intentions and beliefs • Behavioral intentions • Intention strength influences success • Attitudes and subjective norms • Attitudes: positive or negative beliefs about performing a particular behavior • Subjective norms: beliefs that important persons believe behavior should be performed/not performed

18. (Inter-)Personal Theories • Stages of Change (the Transtheoretical Model) • Pre-contemplation stage • Individuals are uninterested, unaware, or unwilling to make a change • A cue to action stimulates progression to next stage • Contemplation stage • Individuals are thinking about making a change • Weigh the pros and cons • Preparation stage • Individuals prepare to implement changes • Set SMART goals; self-assessment; develop a realistic plan; get the support of friends and family; think about solutions to potential barriers • Action stage • Individuals implement change plans • Revisit your goals and change plan • Maintenance stage • Individuals are trying to maintain a change • Find fun and creative ways to maintain positive behaviors • Relapse happens – be prepared – Get help

19. Making Changes • If you’re not thinking about making a change • Get educated; do a self-assessment; reevaluate • If you have been thinking about it • Get more info & weigh the pros and cons • If you’re ready to take action • Choose a target behavior • Select one or two related behaviors to change • Set SMART goals to improve your chances of success • Specific, Measurable, Attainable/healthy, Rewarding, Time oriented • Shaping: Set mini goals and take it one step at a time • Develop a realisticplan • Map out how you will get from point ‘A’ to point ‘B’ • Get the support of friends and family • Think about solutions to potential barriers • If you’ve started taking action • Revisit your goals and change plan • Make necessary modifications • If you’re trying to maintain a change • Find fun and creative ways to maintain positive behaviors • Relapse happens – be prepared • Get help

20. Conclusion

21. Do not let what you cannot do interfere with what you can do. John Wooden

23. Resources • Health education as an occupation • Bureau of Labor Statistics, U.S. Department of Labor • http://www.bls.gov/oco/ocos063.htm • Health education credentialing • National Cancer Institute, National Institutes of Health • Theory at a Glance – A Guide for Health Promotion Practice • http://www.cancer.gov/theory.pdf • Health education theory • National Cancer Institute, National Institutes of Health • Theory at a Glance – A Guide for Health Promotion Practice • http://www.cancer.gov/theory.pdf