2. ??? ????? ? ??????? ????? ??????? The Role of Education on Family Health

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4. Is There a Difference Between Health Education and Health Promotion? Health education: learner directed Health promotion: broader concept directed toward advocating health: Individual and community education Environmental change Policy changes Economic changes Shifts in societal norms

5. I. What is Health Promotion? A broad field encompassing educational, social, economic, and political efforts Practiced in many settings An unifying concept that brings together many separate fields Allows people to take control and responsibility for their health

6. II. The Triad of Health Promotion Prevention Health Protection Role of Health Education Relationships Among the Triads

7. Prevention Primary Prevention – interventions to avert disease, illness, injury, or deterioration Secondary Prevention – identifies disease at its earliest stages and applies appropriate measures to limit the consequences Tertiary Prevention – prescribes specific interventions to limit the effects of disabilities and diseases and to prevent recurrence of disease

8. Health Protection Legal or fiscal controls, regulations and policies, and voluntary codes aimed at positive health Health promoters overcome many health barriers to health protection

9. Role of Health Education The core of the total health promotion program A planned process which usually combines educational experiences to establish healthy behaviors Educate individuals, media, elected officials, and community leaders about health

10. Relationships Among the Triad Triad should be viewed as an interlocking set of spheres of activity Seven domains produced by the relationships

11. III. Framework for Health Promotion Three levels of concern and action Health challenges Health promotion mechanisms Implementation Strategies Explores biopsychosocial processes that motivate individuals to engage in behaviors Health promotion triad runs through framework Most important challenge is reducing health inequities between low- and high-income populations

12. IV. Special Themes in Health Promotion Empowerment – people assuming control over their lives Ecological perspective views as a product of the individual and subsystems of the ecosystem (family, culture, physical, social environment) Community organization – multi-phased process helping to produce change and develop the community Individual behavior plays a key role in one’s health

13. The concept of health The concept of health is defined as the state of body and mind which affords the individual the ability to strive toward his/her functional objectives and his/her culturally desired goals.

14. What is Health Education?

15. Popular Definition of Health Education Any combination of learning experiences designed to facilitate voluntary adaptations of behavior conducive to health. Green, Kreuter, Deeds, & Partridge, 1980 Ask class what the italicized words suggest: Use the definition below to assist with answer. A deliberately planned, structured learning opportunity about health that occurs in a setting at a given point in time and involves interaction between an educator and a learner. Bates & Winder, 1984 Ask class what the italicized words suggest: Use the definition below to assist with answer. A deliberately planned, structured learning opportunity about health that occurs in a setting at a given point in time and involves interaction between an educator and a learner. Bates & Winder, 1984

16. Ultimate Goal of Health Education? Enable people to increase control over their health and quality of life. Empowered learners feel competent and confident about making health decisions that are right for them.

17. Health Education Produces Health Literacy Capacity of individuals to obtain, interpret, and understand health information and services. Competence to use such information and services in ways which enhance/maintain health of self and family members.

18. World Health Organization (WHO) has recently defined health literacy more broadly, as follows: Health literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Health literacy means more than being able to read pamphlets and successfully make appointments. By improving people’s access to health information and their capacity to use it effectively, health literacy is critical to empowerment. (WHO, 1998)

19. Whatever definition you choose… “…one fundamental principle must guide the work of health educators: Individuals Families, and Communities Can be taught to assume responsibility for their own health and, to some extent, for the health of others.” Butler, 2001

20. The challenge is… “…to find the most productive ways to influence voluntary individual and community behavior without violating individual freedoms ...” Butler, 2001 Have students brainstorm examples of how individual freedoms might be or have been violated with policies relating to public health Possible answers: helmets; gun control, safety belts, cigarette taxes, alcohol taxes, fat taxes, breathalyzer ignitions, criminal penalty for not immunizing children, no smoking policies Where do you draw the line?Have students brainstorm examples of how individual freedoms might be or have been violated with policies relating to public health Possible answers: helmets; gun control, safety belts, cigarette taxes, alcohol taxes, fat taxes, breathalyzer ignitions, criminal penalty for not immunizing children, no smoking policies Where do you draw the line?

21. Effective Health Instruction “What to teach and how to teach it.” Dalis, 1994 Knowledge does not always change attitudes or behavior Attitudes are not always consistent with behavior So we must…So we must…

22. Effective Health Instruction Conduct interventions to reach a number of generic outcomes including: Skill development Values awareness Concept and information acquisition and application Opinion development and discussion Decision making We also must address the influence of culture. Culture affects decision making, attitudes, and values. For example, an educational intervention that is effective in Wyoming may not be in Southern California or Alabama.We also must address the influence of culture. Culture affects decision making, attitudes, and values. For example, an educational intervention that is effective in Wyoming may not be in Southern California or Alabama.

23. The process of health education… Is a part of a sequential program that introduces concepts at appropriate learning levels and that is based upon what was learned previously, which forms a basis for what is to be learned in the future. Is a planned opportunity to learn (intervention) about health with stated goals, objectives, activities, and evaluation criteria Occurs in a specified setting Occurs at a specified timeIs a planned opportunity to learn (intervention) about health with stated goals, objectives, activities, and evaluation criteria Occurs in a specified setting Occurs at a specified time

24. The process of health education… Emphasizes in a comprehensive manner how various aspects of health are interrelated and how all aspects affect quality of life Includes interaction between a qualified educator and learner.” Butler, 2001 People who identify themselves as health educators and who practice in other settings are sometimes inadequately prepared. Many physicians, nurses and chiropractors do health education but are not prepared. Nurses are better. Many believe it is part of their job but that they are not prepared to do it or have the motivation to do so. This really gets to what I believe is the main barrier or misperception to more quality health education in the US. Many people educate about health (anybody can) but are they doing it effectively. By calling oneself a health educator only because they educate about health in their job diminishes the profile of qualified health educators. However, it is health educators who are academically prepared to carry out the process of health education. People who identify themselves as health educators and who practice in other settings are sometimes inadequately prepared. Many physicians, nurses and chiropractors do health education but are not prepared. Nurses are better. Many believe it is part of their job but that they are not prepared to do it or have the motivation to do so. This really gets to what I believe is the main barrier or misperception to more quality health education in the US. Many people educate about health (anybody can) but are they doing it effectively. By calling oneself a health educator only because they educate about health in their job diminishes the profile of qualified health educators. However, it is health educators who are academically prepared to carry out the process of health education.

25. Health Education Practice “…is that multidisciplinary practice…concerned with designing, implementing, and evaluating educational programs that enable individuals, families, groups, organizations, and communities to play active roles in achieving, protecting, and sustaining health.” Report on the Joint Committee on Health Education Terminology (1990).

26. Steps to Develop a Health Education/Promotion Program Assessing the needs and assets of the target population Prioritizing needs based on available resources, available data, & experience Developing appropriate goals and objectives Creating an intervention that considers the peculiarities of the setting Implementing the intervention Evaluating the results May do all steps with a program or only work extensively with one step Show overhead 1.5 cotrell May do all steps with a program or only work extensively with one step Show overhead 1.5 cotrell

27. Home and Family Influence on Education Active capital: where parents are active and interact with children and schools and community. Passive capital: parents provide children with resources for education.

28. Active and passive capital Both types of capital can influence the educational achievement, however, active capital in particular can have a significant impact. e.g. John Stuart Mill at an age before most children attend school was taught Latin and Greek by his father…he most likely did not have extraordinary genes, and his fathers’ learning was no more extraordinary than some men of the time...the central difference was the time and effort spent by his father with the children on intellectual matters.

29. Parenting Styles: Authoritarian Style – based on rigid adult oriented rules. Authoritative Style – based on firm consistent control Permissive Style – based on accepting, positive and warm approach in conjunction with few demands. Indifferent-uninvolved – barely involved with family life.

30. Other factors in parental influence: Parental Encouragement – can be active or passive and tends to have a positive effect on a educational programs. Parental Expectations – can have an effect on post-secondary expectations

31. Parents education Parental Education – tends to have a strong impact on all other factors because parents with higher education tend to spend more time with children helping with homework, and difficult assignments.

32. Family Needs Communication Needs Information Needs Guide on life Tasks Consultation Needs Economic and Financial Needs

33. Family Education Individual Education Group Education Mass Education Self Education

34. New Ideas and Practices Awareness Interest Evaluation Trial Adoption

35. The Family Perspective Friends Support Group Members Pamphlets Medical and Rehabilitation Team Library Mass Casual Acquaintances (e.g. waiting room) Co-Workers Internet Referrals Books Attitudes Culture

36. Practice of Health Education Individual and family Education to general public T.V Radio Press Films Health magazine Posters Health exhibition Health museum

37. Group Health Education Lectures Film and charts Group discussion Panel discussion Symposium Workshop Institute Role playing Demonstration Programmed instruction Stimulation and exercise

38. Keep in mind Human Behavior is Complex Participants/clients/patients base their opinion on their perception How relevant the program or health education seemed to be in terms of their needs How interesting it was in terms of subject matter and learning activities Tips: Assess the learner perceptions early Adapt/adjust activities if needed

39. Stages of Successful Education

40. Peoples Education TIPS Discuss; DON’T LECTURE! Consider circumstantial & socio-economic factors Respect cultural/spiritual beliefs and attitudes Ask the people what they understand about the health issue Assess the people’s readiness for change Keep it simple Reinforcement, reinforcement, reinforcement Relapse is part of changing behavior

41. What is principallywrong with Health Education?

42. Health Crisis is running faster

43. Health Education is moving in the right direction – but much too slowly Do you Agree?

44. Where is the NGO’s

45. Where is other Disciplines

46. Is it possible to use Internet, Website, Weblogs and…

47. The Internet

48. People online (in millions)

49. Appropriate technology can revolutionize… The delivery system of products and services The way we communicate The way we use and view television The way we individualize and personalize education The way we internalize, understand, and use massive amounts of data

50. Medical Doctors and other Health Professionals as Consultants of Health Educators

51. Medical Doctors as Health Educators

52. We Should to Think If we have so many best practices

53. The Last Word “I never teach my pupils. I only attempt to provide the conditions in which they can learn.” Albert Einstein

54. The role of health education The role of health education should be to impart knowledge which will assist individuals in making personal choices about lifestyles, values, and goals. Health education should recognize that notions of health are human constructs which are restricted by man's interpretation of the functional integrity of the body and mind and relative to the activities and interests of individual societies. The function of health education should be to impart knowledge for the purpose of developing the powers of reason and judgment in order to help people make their own choices about patterns of living which enhance the well functioning of the body and mind.