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Health Education in the Community. Theoretical Bases. Theories describe, explain, and predict behaviors within a functional framework Theories about health education and behavior change help nurses understand behavior and develop useful strategies that influence people’s health.
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Theoretical Bases • Theories describe, explain, and predict behaviors within a functional framework • Theories about health education and behavior change help nurses understand behavior and develop useful strategies that influence people’s health
Advocacy Barriers Benefits Cognitive dissonance Empowerment Motivation Readiness Self-efficacy Theoretical Bases: Concepts
Theoretical Bases: Learning Theory Assumptions of adult learning theory: • Adults perceive themselves to be self-directed: They want to have a say in what they learn • Adults have a variety of life experiences and are insulted if these experiences are ignored: The wise teacher will build on these experiences
Theoretical Bases: Learning Theory Assumptions of adult learning theory: • Adults learn better when they see an immediate need: They are goal directed • Timing education to coincide with an immediate need is more effective because the learner will see the immediate goal and be ready to learn
Theoretical Bases: Behavior Change Theory • Health belief model • Harm reduction model • Goal-setting theory • Theory of reasoned action • Social learning theory • Diffusion theory • Social marketing theory
Transtheoretical Model • Precontemplative • Contemplative • Preparation • Action • Maintenance • Relapse
Consciousness raising Dramatic relief Environmental reevaluation Self-reevaluation Self-liberation Helping relationships Social liberation Counter conditioning Stimulus control Reinforcement management Processes to Enhance Progression Through Stages
The Health Education Process • Health education is a process of planned teaching and support activities that help people learn • The education process follows the format of the nursing process (assessment, planning, implementation, and evaluation)
Assessment: What to Assess • Client understanding of the problem in question • Client perception of need to change • Motivation to change: severity of problem and risks caused by the problem • Readiness to change
Assessment: What to Assess • Self-efficacy • Perceived benefits to change • Perceived barriers to change • Psychosocial issues • Learning skills
Planning • The nurse and client discuss learning needs and goals and then negotiate to produce a list of learning objectives • The goals and objectives provide direction for implementation and guide evaluation • Objectives are specific and measurable • Objectives address different domains of learning
Domains of Learning • Cognitive • Psychomotor • Affective
Implementation • Design teaching based on assessments of individual clients • Develop educational objectives with input from the learner • Create a learning environment • Keep things simple
Implementation • Focus on one issue at a time • Be sure written materials are appropriate • Be specific • Avoid threatening messages that generate fear • Explain what you will be teaching and why it is important
Implementation • Provide for success • Use a variety of teaching methods • Provide visual learning materials • Show the client what is expected • Skills require practice • Involve all senses in practice sessions
Implementation • Develop mechanisms for support • Discuss resources for further information • Review major points of each learning session • Keep learners involved: Ask for feedback and evaluation
Evaluation • Evaluation is a process of gathering information to assess the extent to which learning objectives have been met or not met • All evaluation methods should be based on the learning objectives • Summative evaluation • Formative evaluation
Health Education in Communities • Individuals, families, & groups • Discharge teaching • Community-based teaching
Advantages to Teaching in Client’s Home • Nurse can assess the client’s environment and make changes to the teaching plan to compensate for problems and to take advantage of strengths • The family can be more easily involved
Advantages to Teaching in Client’s Home • The client will usually be more comfortable in his or her own environment • The client will be learning in the environment in which he or she will be using new information to perform new skills and behaviors
Community • Health education at the community level begins with community assessment • Planning requires community involvement • Encourage an implementation process that helps a community meet its own needs • Effective evaluation determines progress toward goals and identifies goals not met
Community Data from evaluation are used to: • Determine if unmet goals are still a priority • Plan interventions to address unmet goals • Assess the impact of goals that have been achieved • Assess evolving needs • Establish new community goals and objectives
Ethical Issues in Health Education • Manipulation of behavior versus information dissemination • Obligation of nurses to keep up with advances in health care • Social and economic barriers related to growing gap between classes • Community and cultural norms