Health Education

Presenter: Zehra ParvaniAcknowledgement: Yasmin Khowaja

By the end of the class the learners will be able to:Define health education, teaching and learningIdentify the goals of health educationDiscuss the role of health education in PHCList levels of education with examples List the advantages of imparting health educationAnalyze the steps required for health educationDiscuss models used for health education Objectives

Describe the methodologies for imparting health educationDiscuss the domains of learningDiscuss few essential principles of teaching and learningFormulate a teaching plan to conduct session at community level

Health education comprises of consciously constructed opportunities for learning involved some form of communication designed to improve health literacy, including improving knowledge, and developing life skills which are conducive to individual and community health. Health Education

OREducation that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.

OR

In simple aspect health education is planned attempt to change what people think, feel and do, with a goal of promoting higher level of health.

ORIn broader aspect health education is a process that informs, motivates and helps people to adopt and maintain healthy practices and life styles, advocates environmental changes as needed to facilitate this goal, and conducts professional training and research to the same end.

Health education aims to produce positive behavior changes in individuals and communities. It is a tool which enables people to take more control over their own health and over the factors (environmental, social, person, etc) which affect their health.

Aims Of Health Education

It helps people understand that health is the most valuable community asset; and to help them achieve health by their own activities and efforts. To develop a sense of responsibility for improvement of their health as individual members of the family and communities. To develop scientific knowledge, attitude, skills on health matters to enable people to develop correct habits.

To alter behavior which may have direct or indirect influence on spread of disease. To educate people for proper use of health services. To create in him an interest in his and of other family members health and well- being. To create in him a desire to support Health Education Program in his area.

Health education is one of the 8 elements but it is important strategy in all these, especially in MCH and child care. According to PHC approach, education should be a process which enables people to:Define their own problems and needsTo understand what they can do about these problems and needs with the available resourcesDecide on the appropriate actionHealth Education And PHC

Objective of these plans emphasize that: Public education and awareness should be increased regarding the role of lifestyles and behavioral choices and in prevention, causations and management of communicable and non communicable diseases, including trauma and mental illness.The National Ninth Five-Year Plan (1998-2003) And Perspective Plan For 2003-13

Grass based community based organization like:Schools & CollegesWork-siteHomesAdult learning (literacy) centreSenior citizen homesCommunity Based Venues for Health Education

Faith community setting:Religious places like Mosques, Churches, Temple Health Care Setting:Primary Health Care providers officesHealth maintenance Organization (Community Centers)Hospital wards, clinics (Out Patient Departments- OPDs)

In Government: At Federal level health education cellDistrict health education officesNational program for family planningPrimary health care workersPrivate Organization: Primary health care set-up ( run by CHN) Home visits Lane meetings Individual Counseling

Pakistan Health Care System and Health education

Schools: Child to child education Health festivals

Special health days: Celebration of highlighted important dates with health issues such as World Diabetes Day, Polio Eradication, Mental Health Day.

Primary education: Purpose: To prevent occurrence of any health problems in order to maintain the quality of life.Example: Educating a patient about balanced and fiber diet who has high risk of Diabetes.

Levels Of Health Education

Secondary education:Purpose: To prevent complications, limit disability in case of presence of a reversible health problem and to help client cope with the situation.Example: Help to adjust habits in case of Diabetes

Tertiary educationPurpose: Restoration of the maximum level of function and health status when the problem is irreversible.Example: adjust eating habits to ensure maximum health and minimum complications of diabetes like neuropathy.

Disseminate informationEnsure safety & securityPromotion of healthMaintenance of present healthReduces risks and medication errorsRecognition of early onset of signs & symptomsPrevention of complicationsRestoring optimal level of wellness (Rehabilitation)Advantages Of Health Education

Before planning a session, following questions need to be asked by self:What is the problem?Who are my learners?What do I want them to be able to do and know?Where and for how long will teaching take place?What methods will be used?Planning A Health Education Session

What visual aids will be used?How will I know that how effective the teaching was?

Meet, greet & introduce yourself, develop rapport and understanding with clientsShare your visit objectives with themPlan meetings at suitable time Develop trust & working relationGet awareness about the language, customs, values, beliefs and habits of communityAsses knowledge and practices of communityIdentify and list the health problemsSteps Of Health Education

Group the problems as health problems, environmental problems, social & cultural problems & economical problems

Steps Of Health Education

Discuss & Prioritize health problemsDevelop Teaching PlanConduct teachingFeedback & Follow upReassess and restart.

Prioritization

S. NO. Problem ListPrevalenceSeveriousnessDo abilityCommunity ConcernTotal01Arthritis+++++++17502Diabetes Mellitus+++++++++++27509Hypertension

+++++++++++275

AssessmentCollect, categorize and sort datato identify the problem list

Planning Negotiation of learning goals b/w nurse & client to develop teaching plan for priority learning need

Effective Community Health Education

Implementation:Design plan to meet learning needs of clientsand implement it

EvaluationGather information to define extent of learningto evaluate accomplishment of goals

Stages for Health EducationStage of SensitizationStage of PublicityStage of EducationStage of Attitude ChangeStage of Motivation and ActionStage of Community Transformation (Social Change)

Implementation Of Health EducationModel 1 for behavior change:

GoalSmoking EducationHealth consciousnessI know smoking is injurious to health.knowledgeI know the effects of smoking on me.Self-awarenessI am aware that I am smoking too much.Attitude ChangeI believe it is important to change my habits.

Decision MakingIll limit my smoking to one pack per day.Behavior changeI now smoke less than I do.Social changeHigher taxation on smoking, advertising banned.

Model 2:Another model describing change process is AIETA model:Awareness has general informationInterest willing to learn because there is a felt need.Evaluation weights the pros and cons of the practice and its usefulness to person, family; results in a decision to try or reject the strategy for changing behavior.

Trial decision is put into practice and implemented.Adoption person (or group) decides the practice is good and adopts it.

Teaching: Is the process of carrying out those activities that experience has shown to be effective in getting students to learn.

Learning: Learning is the process of information we encounter, which leads to changes or an increase in our knowledge and abilities.

Teaching And Learning

Cognitive: The cognitive domain is knowledge or mind based. It has three practical instructional levels including fact, understanding, and application.

Learning domains

Fact Level: Verbs includes: define, identify, and list.

Understanding Level: Verbs includes: describe, compare and contrast. Application Level: Verbs includes: explain, apply, and analyze.

Psychomotor Domain: The psychomotor domain is skill based. The three practical instructional levels include imitation, practice, and habit.

Affective Domain: The affective domain is based upon behavioral aspects and may be labeled as beliefs. The three levels in the domain are awareness, distinction, and integration. The verbs for this domain is generally limited to words like display, exhibit, and accept and these will apply at all levels.

All learners will learnAll learners can learn much high standards regardless of their race, ethnicity, family, income, gender, etc.All learners do not learn in the same way or at the same pace.Learning is not limited to school. It can happen anywhere.Principles Of Effective Teaching & Learning

Consider learning process: Donot teach unless the student wants to learn. Interest: find real or felt needs; create self-awareness Participation: Ensure active participation of learners Known to unknown: Start with what already is known to community

Comprehension: Ensure understanding of content, use language people know. Are they literate? Are they able to interpretate visual aids? Reinforcement: Repetition is needed as a booster dose.

Motivation: Primary and secondary motives-latter include praise and love, rivalry, rewards and punishment, recognition are important to facilitate learning.

Learning by doing: Different learning styles, use of different senses for learning facilitate the learning.

Know the customs, habits, need etc.: Use truthful health facts. Attractive and acceptable media to get active participation by learners.

Good human relationships: To create better learning atmosphere; Build rapport to convince leaders agents of change "for bringing change through health education.

Andragogy: The art and science of helping adults learn. It refers to learner-focused education. Its characteristics include:

Self concept Self-directed personality Past life experience, knowledge & time perspective Readiness and internal motivation and incentives are more important for andragogy. Teaching Methodologies

Pedagogy: Literally means the art and science of educating children. It is a teacher- focused learning. Its characteristics include: It is teacher directed who assume learner knows nothing Learner is a dependent personality It is considered to be a traditional type of teaching Here external rewards and punishments are motivators.

Lecture methodGroup discussionsPanel discussionsRole playsCase studiesStory tellingTrip or tourDemonstrationUse of Audio-visual aids

Chalk boardMagic board Flip Charts Flash card games Puzzles games Pictures Posters Models PhotosDrawings

Teaching Strategies/MethodsTeaching Aids/Tools

Teaching Methods for DevelopmentLevels

Preschool Simple language, games, songs, rhymes, demonstration/ return demonstrations. Schoolage Language varies with grade level and cognitive ability with interactive session. Adolescent Cooperative learning, problem-based learning, discussion, demonstration. Adult Lecture, discussion, demonstration and role play.Senior Lecture, discussion, demonstration, and role plays with respect to mental levels.

Situation analysis: _____________________Assessment/ data collection: _____________Patient/ client data:_____________________Subjective data: _______________________ Objective data: _______________________Socio economic status: __________________Assessment analysis: ___________________Nursing diagnosis: example: knowledge deficit

Health Teaching Plan

Health Teaching Plan Form Date______ Student name_______ Topic ___________ Audience #. _____ Age_____ Sex______ Place _______

Objectives Content Time FrameStrategies Evaluation Cognitive AffectivePsychomotor domainsOut Line

What you intent to teach Goal: Role playsLecturesPresentationArt GalleryGuided Imaginary

Objectives should be:SMARTSpecificMeasurable Achievable Realistic Time frameOr RUMBA

Design teaching based on assessments of individual clients Create a learning environment Keep things simple Focus on one issue at a time Be sure written materials are appropriate Be specific Avoid threatening message that generate fear Explain what you will be teaching and why it is important Develop mechanisms for support Implementation Of Teaching Plan

Discuss resources for further information Review major points of each learning session Keep learners involved: Ask for feedback and evaluation.

ScenarioMr. Aslam, 56 years old man, started having polyuria and poly dypsia. He had not been hospitalized before and never goes to clinic unless it is highly important. He is illiterate and father of 4 children. His father also had diabetes and had died of heart attack 8 years back. Mr. Aslam was insisted to go to clinic by her daughter and there he diagnosed to be having Diabetes. He was in a major shock and was not ready to accept the fact.

After 2 months, you find him more receptive and call him to diabetic clinic. Today he comes to you in a clinic:Plan a health education / teaching on one of the problems Mr. Aslam is facing.

References:Allender, Ann, J., & Spradley, B. (2001). Health Promotion through Education.Community Health Nursing: Concepts and Practice (5th ed). pp. 152-162. Lippincott: Philadelphia.Basavanthappa, B.T. (2006). Community Health Nursing. New Delhi: Jaypee Brothers.Chagani, J.A. (2002, August 29). Health Education ` A missing pillar. Arab News pp.13. Glanz., Karen., Rimer., Barbara, K., Lewis., & Marcus, F. (2002). Health Behavior and Health Education (3rd ed.).Illyas, M., Bair, L. A., & Rashid, S. (2000). Health Education and Communication. In Illyas, M., Malik, G.Q., Ansari, M.A., Mubasher, M., & Khan, I.A. (Editors) Community Medicine (5th ed.). pp. 1083 - 1096). Karachi: Time Traders.