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Health education

community medicine

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Health education

  1. 1. Dr. Dalia Abdallah El-Shafei Lecturer, Community Medicine Department, Zagazig University
  2. 2. Definition Goals Concepts “Levels” Dimensions Program
  3. 3. Definition Planned opportunity for people to learn about health & make changes in their behavior. [It includes] Raising awareness Providing information Motivation & persuasion Equipping with skills & confidence
  4. 4. Goals of health education I. Health consciousness II. knowledge III. Self awareness IV. Attitude change V. Decision making VI. Behavior change VII. Social change
  5. 5. Health consciousness Increase awareness of health status knowing Knowledge Give information about a problem that people are already aware about it knowing Self awareness Clarifying values about health. Helping people to identify what is really important to them Feeling Attitude change Change what people feel, believe and what their opinion about Feeling Decision making Decide what to do in the future about health in general or a particular health problem knowing & feeling Behavior change Do something about health Doing Social change Complex goal healthy choices easier choices
  6. 6. Social change goal Complex goal of making Healthy choices Easier choices Changing social, physical environment so that people are encouraged to adopt health behaviors.
  7. 7. Effect of physical exercise on health 1. Conscious exercise is healthy. 2. Knowledge strength my body & heart. 3. Self awareness feel unfit. 4. Attitude change believed exercise is valuable 5. Decision making will join sport club. 6. Behavior change go to club, walk to work ext.. 7. Social change sport facilities available
  8. 8. Effect of physical exercise on health 1 & 2 Know 3 & 4 Feel 5 Know & Feel 6 Do 7 Healthy choices are easier
  9. 9. 3ry 2ry 1ry • How to make best of remaining health potentials “Rehabilitation” • Restore former state of health [improve compliance with ttt or change harmful behavior • Prevent illness • Improve quality of healthy life Concepts of HE
  10. 10. Dimensions of HE 1. Whole person [physical, mental, social]. 2. Life long process. 3. All points of health & illness [1ry, 2ry & 3ry]. 4. Directed towards [persons, families, group & community.] 5. Help in making health choices easier choices 6. Involve [formal & informal teaching]. 7. Wide range of goals [information, attitude change, behavior change & social change].
  11. 11. Health Education Program
  12. 12. Link between knowledge attitude & behavior -Social class. -Education. -Age. - sex. Beliefs - Attitudes - Intention - Behavior. -Peer. -Pressure. -Culture. -Norms. Knowledge experience Expectation of others
  13. 13. Planning • Situational analysis • Planning. Implementation • Relationship between educator & client. • The communication styles. • Barriers. Evaluation - Structure. - Process. - Outcome.
  14. 14. Where we are ???????????? Situation analysis
  15. 15. Situational analysis Identify Consumers Identify Needs & Priorities Decide on Goals & Objectives Identify Resources
  16. 16. Identify consumers “WHO” NO. Sex Age Education Occupation KAPCulture Language Motivation Expectations Experience
  17. 17. what sort of need it is? Who decided that there is a need? What are the grounds for deciding there is a need? Is HE the answer to the need? Assessing Needs Is it a health promotion issue? Is prevention effective? Can it be done & will be successful with that group? Do we have sufficient resources [knowledge, materials]? Do we have means for prevention? Why produce worries if we have nothing to do? What was done by others? Setting HE priorities 2. Identify needs & priorities: It will determine the objectives & outcome
  18. 18. Health Education Needs Felt or perceived needs What people want but not necessary expressed Normative 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
  19. 19. 3- Decides Goals & Objectives  Goal = Broad Aim  Goals will be reached by the end of the program.  Objectives should be “SMART”:
  20. 20. Identify Resources 3Ms + T The educator characteristics & their rules? Client capabilities? People can influence clients? Exciting polices or plans? Facilities & materials?
  21. 21. • Best for Objectives • Accepted by Consumer • Suitable for Content Content & Methods • Self • Peer • Client Evaluation “ Structure-Process- Outcome” Planning of the program
  22. 22. Interesting Acceptable Provide opportunity Appropriate Involve learner Feasible Readily available Cost efficient Can be used Achieve objectives Guidelines to select the HE method
  23. 23. 2- Plan evaluation methods Self evaluation: • Did we do a good job? • Satisfied or not? • How can improve? Peer evaluation: • A colleague evaluate. Client evaluation: • Feedback? • Type of attitude?
  24. 24. • Factors related to Educator • Factors related to Clients Relationship “Educator & Clients” • Authoritarian or Paternalistic • Permissive or Democratic Communication Styles • Social & Cultural gab • Limited Receptiveness • Limited Understanding & Memory • Insufficient Emphasis on education • Delivered messages are Contradictory. Barriers II. implementation
  25. 25. 1. Relationship between educator & client: a. Factors related to educator Judging Recognize client’s Knowledge, Believes, Point of view Two-way discussion Encourage client to think for himself Expert-role Create Open Trustable Atmosphere
  26. 26. Situation clients adopt –ve feelings  Ignoring 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. b. Factors related to client [Feelings that lead to either accepting or refusing the message]
  27. 27. Situation clients adopt +ve feelings  The educator praises effort of the client.  The educator doe not imply the client’s behavior as morally bad.  Minimize feelings of helplessness.
  28. 28. 2. The communication style: b. 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. a. Authoritarian or paternalistic style “Strict obedience” +ve aspects: - Clear guidelines. - Easily resolve the problem. - ve aspects: - - ve attitude of the client
  29. 29. Barriers Social & Cultural gab Limited receptiveness Limited understanding & memory Insufficient emphasis on education Contradictory messages
  30. 30. 3. Barriers: a. Social & Cultural gab between educator & client.  Different Social class. Religious beliefs. Values Gender. b. Limited receptiveness of client. Illness, Tiredness, pain, Emotional distraction or being too busy.
  31. 31. c. Limited understanding & memory.  Limited intelligence.  Poor memory.  Use of medical jargon. d. Insufficient emphasis on education by the health professional  Educator is too confident so acts in reluctant way.  Educator is too busy and didn’t prepare the materials.  Educator is in a hurry & not enthusiastic.  Educator doesn’t believe in the value of HE.
  32. 32. d. The delivered messages are contradictory.  Different specialties say different things.  Family, friends & neighbors contradict the HP.  Expert keep changing their minds.
  33. 33. III. Monitoring & Evaluation Systematic & logical method for making decisions to improve HE program Structure Place Materials Aids Process Outcome Health consciousness Knowledge Self awareness & attitudes Decision making Behavior Social
  34. 34. 1- Structure  Evaluation of components: 1. Place. 2. Aids. 3. Materials. - Written feedback from the learner [evaluation sheet]. - Verbal forms or non verbal as [facial expressions or enthusiasm or participation level]
  35. 35. 2. Process  It 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
  36. 36. OutcomeSocial Behavior Decision making Self awareness & attitudes Knowledge Health consciousne ss
  37. 37. 1. 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. 2. Changes in knowledge:  Interviews & discussion between educator &clients  Observation of use of knowledge by the clients.  The results of the pre & post tests.
  38. 38. 3. Changes in self awareness & attitudes:  Observing the changes in what the clients do during HE.  Ask the clients to rate their attitudes. 4. Changes in decision making:  What the client proposes to do whether verbally or in writing.
  39. 39. 5. Behavioral changes “records”:  Changes in no of clients attending the service.  Changes of smoking behavior noticed from questionnaire. 6. 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].
  40. 40. Research “Subjects” Researchers Communities
  41. 41. Research Participants Researchers Communities Being the subject of research is different from being a participant in research
  42. 42. Definition  In short people share the same experiences and belong to the same culture.
  43. 43. Role of community in inducing change  It 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.
  44. 44. Ways of developing Community Participation 1. Be open about policies & plans. 2. Plan for the community expressed needs. 3. De- centralize planning. 4. Develop joint forum & network. 5. Provide support, advice & training for community groups. 6. Help them with fund & resources. 7. Support advocacy project