HEALTH EDUCATION & PROMOTION

• Health education should be viewed within the changing context of health and disease; within the changing health picture where lifestyles play an important role and within the accepted definition of health.
• Alma-ata Declaration

  • Health is a fundamental human right and that the attainment of the highest possible level of health is a most important worldwide social goal.
  • The existing gross inequality in the health status of the people particularly between developed and developing countries is politically, socially and economically unacceptable.
• Health Education

  • “Educe” Latin for “to lead out”
  • Leading out what people already “know” and “believe” and do about their health
• Health Education

  • Modifying those that are undesirable, and Developing desirable behaviors that are conducive to health.
• Health Education

  • Any combination of learning experiences designed to facilitate voluntary adoption of behavior conducive to health. (– Green et al, 1980)
• Health Education

  • Comprises of consciously constructed opportunities for learning involving 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 Promotion Glossary, WHO, 1998)
• HEALTH LITERACY

  • 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.
  • (Joint Committee on Health Education and Promotion Technology)
  • (Sharma & Romas,2008)
• HEALTH LITERACY: Domains

  (Zarcadoolas, Pleasant, and Green, 2003)

  1. Fundamental Literacy/Numeracy
  2. Science and Technology
  3. Community/Civic Literacy
  4. Cultural Literacy
• Health Promotion

  • Any planned combination of educational, political, regulatory and organizational supports for actions and conditions of living conducive to the health of individuals, groups or communities.

  (– Green and Kreuter, 2005)
• Health Promotion

  • Process of enabling people to increase control over the determinants of health and thereby improve their health (– World Health Organization, 1998)
• Health Promotion and Education: Foundations

  1. Philosophical - Beacon light, guide, direction
  2. Biomedical - What or Content
  3. Psycho-social - How or the Methods
• Predominant Philosophies

  • Behavior Change Philosophy
  • Cognitive-Based Philosophy
  • Decision-Making Philosophy
  • Freeing/Functioning Philosophy
  • Social Change Philosophy
• Biomedical Foundation

  • Microbiology
  • Parasitology
  • Nutrition
  • Environmental Health
  • Occupational Health
• Psycho-Social Foundation

  • Psychology
  • Anthropology
  • Sociology
  • Political Science
• ACTION AREAS FOR HEALTH PROMOTION

  1. Build Healthy Public Policy
  2. Create Supportive Environments
  3. Strengthen Community Actions
  4. Develop Personal Skills
  5. Reorient Health Services
• CLASSIFICATION OF HEALTH PROMOTION STRATEGIES/METHODS:

  • According to focus
  • Use of Behavioral theories
  • According to Target factors
• ACCORDING TO FOCUS:

  1. Focus on the individual

  • The origin of health education/promotion
  • Usually utilized for purposes of secondary and tertiary prevention.

  2. Focus on groups

  • Utilized for a number of persons present in one setting at the same time
  • Appropriate for the purposes of primary, secondary, and tertiary prevention programs

  3. Focus on Whole Population

  • Most of the time utilize mass media to maximize coverage of the target populations prevention
  • Very cost – effective for the purposes of empowerment and for primary
• B. Use of Behavioral Change Theories

  Stages of behavior change

  1. Pre-contemplation - A condition in which people are not thinking about change or have expressed no interest in change.
  2. Contemplation - The period in which people are seriously thinking about the behavior change.
  3. Preparation and Action - Period when an effort to try the behavior change is undertaken.
  4. Confirmation - The period when people can now maintain the new behavior.
• Stages of behavior change and Task of Appropriate Strategies

  1. Pre -contemplation = Create awareness and interest
  2. Contemplation = Change values
  3. Preparation and action = Create opportunity for action
  4. Confirmation = Maintain change
• C. According to target factors:

  • Communication - Targeting the predisposing factors
  • Training - Target enabling factors
  • Community organizing/social mobilization - Targeting environmental and reinforcing factors
• Classification of Communication Methods:

  1. INTERPERSONAL

  • Direct, face-to-face encounter between two groups or groups:

  * INDIVIDUAL - Counselling; individual instruction; home visits; referrals; risk assessment; patient education

  * GROUP - Lecture; small group discussions; forum; seminars

  
  

  2. MASS MEDIA

  • Use of television, radio and print
  • Social marketing and Folk media are relevant strategies/method in health promotion
• Advantages of Interpersonal Communication:

  • Two way flow of communication
  • Can fit to the local/individual needs
  • Allows for immediate feedback
  • Allows for in – depth discussion of a topic
  • High capability to select particular audience
• Skills in Interpersonal Communication:

  1. Use of non – verbal communication
  2. Active listening
  3. Recognizing information about feelings and ideas
  4. Questioning and responding skills
• Skills in Interpersonal Communication:

  
  

  Use of non – verbal communication

  • Important in sharing and interpreting information about feelings
  • Varies from culture to culture
• Skills in Interpersonal Communication:

  Active listening

  • The ability to respond to a person/group in a way that will help them clarify thoughts and feelings
  • A skill that must be learned and developed
• Skills in Interpersonal Communication:

  Recognizing information about feelings and ideas

  • Careful attention must be paid to cues, tone of voice, choice of words , facial expressions and posture
• Skills in Interpersonal Communication

  Questioning and responding skills

  • Questioning and response is fundamental to a successful communication