HEALTH EDUCATION &

Promotion Concepts

Prof. AWATIF ALAM & Prof. ASHRY GAD

Department of Family & Community Medicine

KSU

Definition:

“Health education is the process by which individuals and group of people learn to “:

Promote, Maintain, Restore health Address risks, prevent disease/injury

“Education for health begins with people as they are, with whatever interests they may have in improving their living conditions”.

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

DEFINITIONS OF HEALTH PROMOTION

Green & Kreuter, 1999

The process of enabling people to increase control over and improve their health…

A commitment to dealing with challenges of reducing inequities, extending the scope of prevention, and helping people to cope with their circumstances…

Creating environments conducive to health, in which people are better able to take care of themselves

DEFINITIONS OF HEALTH PROMOTION

BASIC CHARACTERISTICS OF HEALTH PROMOTION

1. Enabling people to take control over, and responsibility for, their health as an important component of everyday life.

2. Requiring the close cooperation of sectors beyond the health services.

3. Combining diverse, but complimentary, methods or approaches.

4. Encouraging effective and concrete public participation.

Health Promotion Action Means:

Build Public Health Policy Create Supportive Environments Strengthen Community Actions Develop Personal Skills Re-orient Health Services Moving into the future

THE TRIAD OF HEALTH PROMOTION

HEALTH EDUCATION

HEALTH PROTECTIO

N

DISEASE PREVENTIO

N

The Health Promotion Triad

Health Education

Health Protect

ion

Prevention

DISEASE PREVENTION

THREE LEVELS

Primary

Secondary

Tertiary

Primary Prevention

SecondaryPrevention

Healthy individual

Biological onset of disease

Risk Factors

Immunization Health EducationProphylaxis

Screening Surveillance

RehabilitationSupport

Asymptomaticsigns

FunctionalStatusSymptoms

and signs

Diagnosis TreatmentComplianceAdherence

The Phases of Prevention in relation to

natural history of disease

Clinical Course of disease

Chronic disease

CureDisability

Death

Tertiary Prevention

Health Promotion Context: Place of Health Education in Public

Health

THREE SPHERES• Health Education• Prevention• Health

Protection SEVEN DOMAINS1. Prevention2. Lifestyle3. Preventive

Policies4. Policy Maker

Education5. Health

Education6. Health

Protection7. Policy Support

HEALTH PROMOTION MODELS

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Health Promotion(Ottawa Charter)

Process of enabling people to increase control over, and to improve, their health…

…. health promotion is not just the responsibility of health sector, but goes beyond healthy life styles to well being

Health Promotion concept recognizes the role of socio-political environment, public policies, health system and access to care, physical environment, culture, and health related attitudes and behaviors towards health and diseases. Health Education targets health related beliefs, attitudes and behaviors of individuals and populations. Therefore, while Health Education plays an important role there is a need to understand that a larger role is played by national policies, social context, cultural values, health system access

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Health Promotion – Framework

Advocacy to make political, economic, social, environmental, cultural, behavioral & biological factors favorable to health.

Enable people by ensuring equal opportunities associated text refers to ‘opportunities for access to information, life

skills, and making health choices (HEALTH EDUCATION contributes to achieving this goal)’ -- [and this enables person to take action]

Mediate a coordinated action by government, health, social and economic sectors, NGOs, Industry, professional & social groups

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Health Promotion Actions

Healthy Public Policies -- for healthier goods & services, healthier environment, equal opportunities

Creation of Supportive Environment Environment - Social, Physical Work, Community, Society levels

Strengthening Community Actions Community participation, empowerment, action. Health

Education also helps in empowering people for effective participation and taking part in actions which make positive changes to environment, health care services, policies

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Health Promotion Actions (contd.)

Develop Personal Skills

By education, information, training

Reorient Health Services Health sector must move in a HP direction beyond

clinical

Respect cultural needs

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Targets of health education: definitions

Health Behaviour: Activity undertaken for the purpose of prevention of diseases, or detecting these at an early stage, or managing them effectively

Belief: A statement or body of statements held to be true by an individual or group.

Attitude: Position, disposition, or manner with regard to a person or thing

AIMS OF HEALTH EDUCATION:

1. To develop a sense of responsibility for health conditions, as individuals, as members of families & communities.

(Promotion ,prevention of disease & early diagnosis and management ). While, as mentioned previously, environment, policy, social context plays a major role towards shaping the health attitudes and behaviors, information, knowledge and skills at personal level are also important to adopt healthy behaviors

2. To promote and wisely use the available health services.

3. To be part of all education, and to continue throughout whole span of life.

Process of health education:

Dissemination of scientific knowledge about how to promote and maintain health),

lead to changes in the Knowledge, Attitudes, and Practices (behavior) related to such changes.

Steps for adopting new ideas & practices :

AWARENESS (Know about new ideas)

INTEREST (Seeks more details ) EVALUATION (Advantages versus disadvant.+ testing usefulness )

TRIAL (Decision put into practice)

ADOPTION (person feels new idea is good and adopts it)

Contents of Health Education

RISK FACTORS: e.g. smoking, drugs, road traffic accident risks

HEALTH ENHACING PRACTICES: e.g. exercise, nutrition OCCUPATIONAL FACTORS: Safety, Hygiene INFECTION CONTROL: e.g. hand washing CHRONIC ILLNESS, MENTAL HELATH: Knowledge about

risks, improvement actions such as promoting togetherness

SEXUAL HEALTH i.e. information about STI HEALTH SERVICES: Information about access,

Awareness about the need to use the health services SPECIAL GROUPS (food handlers, occupations, mothers,

school health)

Principles of Health Education

Interest Participation Motivation Comprehension Proceeding from the known to the unknown Reinforcement through repetition Good human relations People, facts and media: “knowledgeable, attractive , palatable &

acceptable “.

Principles of Health Education

Learning by doing: “ If I hear, I forget If I see, I remember If I do, I know”.

Motivation i.e. awakening the desire to know and learn:

- Primary motives, e.g. inborn desires, hunger - Secondary motives, i.e. desires created by

incentives such as praise, love, recognition, competition.

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Health Education: Individuals

About For example, for Healthy behaviors (e.g. breast

feeding), secondary prevention Settings where education is imparted

Health care settings, Home, Video/Internet Approaches to health education for individuals

Risk assessments in various settings Information, contract, evaluation for behavior

change Methods for health education for individuals

Information provision in-person, print/electronic media

Issues High Cost, Focus on Disease rather than on health

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Health Education: Groups

About Behavior change, supportive environment,

community action, access to care Settings

Health care settings, community, workplace Approaches

Knowledge & skill development Peer learning Training for behavior change

Methods Didactic & experiential methods

Issues Difficult to comprehend and manage group

dynamics, difficult to achieve skills to facilitate groups

Communication in health education:

Education is primarily a matter of communication, the components of which are:

CHANNELS AUDIENCE MESSAGE COMMUNICATOR

- Individual - Conform with - Educator- Media - Group objectives.-----------------------------------------------------------------------------------------

- 2 way - Public - understandable - needs+ interest

of audience

-----------------------------------------------------------------------------------------

- 1 way - Public - Acceptable - ? Content of

message

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Evaluation of health education programs:

There should be continuous evaluation.

Evaluation should not be left to the end but should be done from time to time for purpose of making modifications to achieve better results.

EVALUATION CYCLE:Describe problem Describe program State goals Determine

needed information

Modify program Establish basis for

proof of effectiveness

Analyze &compare Organize data Develop& test Determine data

results base instruments collecting method