Health Education

Presenter: Zehra Parvani Acknowledgement: Yasmin Khowaja

Objectives
By the end of the class the learners will be able to: Define health education, teaching and learning Identify the goals of health education Discuss the role of health education in PHC List levels of education with examples List the advantages of imparting health education Analyze the steps required for health education Discuss models used for health education

Describe the methodologies for imparting health education Discuss the domains of learning Discuss few essential principles of teaching and learning Formulate a teaching plan to conduct session at community level

Health Education 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.

OR Education 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.

OR In 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.

Aims Of Health Education

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.

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 wellbeing. To create in him a desire to support Health Education Program in his area.

Health Education And PHC

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 needs To understand what they can do about these problems and needs with the available resources Decide on the appropriate action

The National Ninth Five-Year Plan (1998-2003) And Perspective Plan For 2003-13
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.

Community Based Venues for Health Education

Grass based community based organization like: Schools & Colleges Work-site Homes Adult learning (literacy) centre Senior citizen homes

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

Pakistan Health Care System and Health education

In Government: At Federal level health education cell District health education offices National program for family planning Primary health care workers Private Organization: Primary health care set-up ( run by CHN) Home visits Lane meetings Individual Counseling

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.

Levels Of Health Education

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.

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 education Purpose: 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.

Advantages Of Health Education

Disseminate information Ensure safety & security Promotion of health Maintenance of present health Reduces risks and medication errors Recognition of early onset of signs & symptoms Prevention of complications Restoring optimal level of wellness (Rehabilitation)

Planning A Health Education Session

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?

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

Steps Of Health Education

Meet, greet & introduce yourself, develop rapport and understanding with clients Share your visit objectives with them Plan meetings at suitable time Develop trust & working relation Get awareness about the language, customs, values, beliefs and habits of community Asses knowledge and practices of community Identify and list the health problems

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

Steps Of Health Education

Discuss & Prioritize health problems Develop Teaching Plan Conduct teaching Feedback & Follow up Reassess and restart.

Prioritization
S. Problem Prevale Severiou Do Commu Total N List nce sness ability nity O. Concern 01 Arthritis Diabetes 02 Mellitus + ++ ++ ++ 175

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275

Hyperten 09 sion ++

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275

Effective Community Health Education

Assessment Collect, categorize and sort data to identify the problem list Planning Negotiation of learning goals b/w nurse & client to develop teaching plan for priority learning need

Implementation: Design plan to meet learning needs of clients and implement it

Evaluation Gather information to define extent of learning to evaluate accomplishment of goals

Stages for Health Education

Stage of Sensitization Stage of Publicity Stage of Education Stage of Attitude Change Stage of Motivation and Action Stage of Community Transformation (Social Change)

Implementation Of Health Education

Model 1 for behavior change: Goal Smoking Education Health I know smoking is injurious to consciousness health. knowledge I know the effects of smoking on me. Self-awareness I am aware that I am smoking too much. Attitude I believe it is important to Change change my habits.

Decision Making Behavior change Social change

Ill limit my smoking to one pack per day. I now smoke less than I do.

Higher taxation on smoking, advertising banned.

Model 2: Another model describing change process is AIETA model: Awareness has general information Interest 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 And Learning

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.

Learning domains

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

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.

Principles Of Effective Teaching & Learning

All learners will learn All 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.

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.

Teaching Methodologies
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.

Pedagogy: Literally means the art and science of educating children. It is a teacherfocused 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.

Teaching Strategies/Methods

Teaching Aids/Tools

Lecture method Group discussions Panel discussions Role plays Case studies Story telling Trip or tour Demonstration Use of Audio-visual aids

Chalk board Magic board Flip Charts Flash card games Puzzles games Pictures Posters Models Photos Drawings

Teaching Methods for Development Levels

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.

Health Teaching Plan

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 Form Date______ Student name_______ Topic ___________ Audience #. _____ Age_____ Sex______ Place _______
Objectives
Cognitive Affective Psychomotor domains

Content
Out Line What you intent to teach

Time Frame Goal:

Strategies
Role plays Lectures Presentation Art Gallery Guided Imaginary

Evaluatio n

Objectives should be: SMART Specific Measurable Achievable Realistic Time frame Or RUMBA

Implementation Of Teaching Plan

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

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

Scenario Mr. 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