Ch. 19 (Exam 2) Community

• The easiest thing to change is knowledge, changing attitudes is the next step, and the most difficult thing to change is behavior
• Thompson's (2010) steps to organizational change can be applied to health education
• How people learn

  • Hearing message
  • Observing
  • Participating
• Factors that influence how learners accept information


  • What they already know
  • What they believe
  • The culture in which they were raised
  • How well they understand
  • How well they relate to the information
• Learning styles


  • Visual
  • Auditory
  • Tactile-kinesthetic
• Domains of learning


  • Cognitive (thinking)
  • Affective (feeling)
  • Psychomotor (acting)
• Each domain has behavioral components that form a hierarchy of steps, or levels, and each level builds on the previous one
• Motivating adult learners
• Cognitive domain


  Includes memory, recognition, reasoning, understanding, application, and problem solving
• Components of cognitive domain


  • Knowledge
  • Comprehension
  • Application
  • Analysis
  • Synthesis
  • Evaluation
• Affective domain


  Attitude changes and development of values
• Nurse's attitudes and values may differ
• It is difficult to change deeply rooted attitudes, beliefs, interests, and values
• Steps to change in affective domain


  • Receive
  • Respond
  • Value
  • Analyze
  • Synthesize
  • Adopt
• Psychomotor domain


  Neuromuscular coordination and motor skills
• In a classroom environment, learners may benefit from observing one another
• Conditions for psychomotor learning


  • Necessary ability
  • Sensory image
  • Opportunities to practice
• The educational process


  • Identify educational needs and develop goals and objectives
  • Select appropriate educational methods
  • Skills of the effective educator
  • Motivational interviewing
  • Developing effective health education programs
• Identify educational needs


  1. Conduct a thorough needs assessment

  2. Prioritize the needs

  3. Consider learner's knowledge, skill, motivation, and available resources

  4. Consider barriers to learning
• Goals


  Broad and general
• Objectives


  Specific, short-term outcomes aimed at achieving a goal
• Population considerations


  • Age- and generation-specific strategies
  • Level of health knowledge
  • Pedagogy
  • Andragogy
  • Culture-specific factors
• By 2050, 50% of U.S. population will consist of ethnic minorities, and cultural competence is essential in presenting written, audio, or visual information
• Benefits of using technology in learning


  • Control the pace of instruction
  • Offer flexibility in the time and location of learning
  • Present an appealing form of education
  • Provide immediate feedback
  • Use a variety of technological applications
  • Use the Internet appropriately
  • Evaluate quality and reliability of Internet sources
• Cognitive learning theory


  Examines learner thought processes, allows for understanding of mental processes, used to encourage self-reflection
• Behavioral learning theory


  Learning is influenced by external forces, positive reinforcement makes learner more likely to complete a task, incentives offered improve behavior
• Social learning theory

  Learning happens by observing others, depending on consequences, learner will imitate or avoid that behavior, takes cognitive and environmental factors into consideration
• Experiential learning theory

  Learning comes from experiences, learners retain and recall information when they are hands-on, involves participation in real-world experiences
• Transformative learning theory

  Learners can change the way they think once they have new information, educator facilitates the learning experience and provides an environment that promotes learning, learner reflects on previous experiences, critical evaluation of perspectives occurs, results in transformation of thinking
• Humanistic learning theory

  Learning is a holistic process, educator acts as a facilitator, provides environment conducive to learning, freedom for students to learn what they are interested in, retention of knowledge is not used to evaluate learner
• Learning and teaching models

  • Health Belief Model
  • Health Promotion Model
  • Transtheoretical Model
  • Cultural Care Theory
• Health Belief Model

  Determines internal motivation to make health-related changes, includes perception of risk of getting illness, modifying factors, likelihood to take action
• Health Promotion Model

  Determines factors that influence motivation to change, focuses on disease prevention and health promotion, includes individual characteristics, behavior-specific cognitions and affect, behavioral outcome
• Cultural Care Theory

  Used to provide culturally congruent care, must consider culture when providing care and education, make effort to learn about other cultures
• Health literacy

  Ability to obtain, understand, and make health-related decisions
• Risk factors for poor health literacy

  • Older adults
  • Low socioeconomic status
  • Medically underserved
• Strategies to improve health literacy

  • Use plain language
  • Identify clients who have low literacy levels
  • Provide supplemental teaching methods
  • Ask client to "teach back" learned material
  • Be honest and admit to not knowing the answer to questions, follow up after doing some research
• Educator-related barriers to learning

  • Fear of public speaking
  • Lack of credibility with respect to a certain topic
  • Limited professional experiences related to a health topic
  • Unable to deal with difficult people
  • Lack of knowledge about how to gain participation
  • Lack of experience in timing a presentation
  • Uncertain about how to adjust instruction
  • Uncomfortable when learners ask questions
  • Want to obtain feedback from learners
  • Concerned about equipment functioning properly
  • Difficulty with openings and closings
  • Overly dependent on notes
• Recipient-related barriers to learning

  • Education level
  • Language barriers
  • Lack of motivation to learn information and make needed behavioral changes
• Strategies to improve recipient barriers

  • Health literacy universal precautions
  • Use of nonmedical, plain language
  • Slower speech
  • Limit content
  • Repeat vital points