Class 4 Health education

Health education 

• Any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes (WHO 2019)

• Fundamental for health promotion 

• Information alone does not change behavior 

Health education Nurses can:

• Assess the learners needs for education related to primary, secondary and or tertiary prevention 

• Assess the underlying structural and social determinants of health that impact the learners ability to learn or make change 

Health education Several key components:

• Involves the use of teaching - learning strategies 

• Learners maintain voluntary control over the decision to make changes in their actions 

• Focuses on behavior changes that have been found to improve health and well-being 

Goals of health education 

1. Help individuals, families, and communities achieve, through their own action and initiative, optimal states of health 

2. Facilitate voluntary actions to promote health 

3. Improve health literacy 

Motivational interviewing strategies 

• Encourage positive evidence-informed changes in lifestyle behaviors

• Empowerment 

• Autonomy 

Protection Motivation theory 

• Developed by Ronald W. Rogers (1975)

• Engagement in health-promoting behavior is based upon 3 factors 

  1. One's beliefs about the severity of the illness

  2. Perceived benefits of change 

  3. Barriers and confidence levels (self-efficiency) in creating change

• Focuses on how fear influences change (ex: social marketing)

Social cognitive theory 

• Also referred to as social learning theory 

• Describes 3 interacting, reciprocal factors 

  1. Behaviour (role modeling)

  2. Cognition (what we think and feel)

  3. Environment (social influences)

• The interplay between these factors is tridirectional 

• People are both observers and producers of behaviors 

• Emphasizes the influence of self efficiency 

Transtheoretical model of change 

• Stages of change model

• Useful for determining where a person is in relation to making a behavior change 

• Health related behavior change progresses through the following five stages:

  1. Precontemplation 

  2. Contemplation 

  3. Planning or preparation 

  4. Action 

  5. Maintenance 

• Useful in determining the person's readiness for learning in relation to changing a behavior 

• Exploring the learners ambivalence 

• Dorans SMART goals (1981)

• Interventions 

Ethics 

• Respect 

• Autonomy 

• Justice 

• Beneficence 

• Shared decision making 

  • Increases clinician awareness and skills in addressing issues that may not be uncovered in an information-giving style of education 

Community and group health education 

• Community-based social marketing 

  • Defined as marketing principles and techniques - such as prompts, messaging, and images 

  • Develop and deliver programs used to promote sustainability and benefit the individual and society 

  • Develop and pilot programs to overcome barriers 

  • Implement the program across a community and evaluate the effectiveness of a program 

Teaching plan

• The written teaching plan represents a package of educational services provided to a consumer or student 

• The plan is written from the learners point of view 

Three domains of learning 

1. Cognitive 

   • Development of new facts or concepts, and building on or applying knowledge to new situations 

2. Psychomotor 

   • Developing physical  skills from simple to complex actions 

3. Affective 

   • Alludes to the recognition of values, religious and spiritual beliefs, family interaction patterns and relationships, and personal attitudes that affect decisions and problem-solving progress 

Cognitive (thinking)

• Teaching strategies 

  • Lecture

  • One to one instruction 

  • Discussion 

  • Audiovisual or print 

  • Computer-assisted/simulation 

• Examples of desired outcomes related to a behavior change 

  • Describes and or explains information relevant to the behavior change 

Affective (feeling)

• Teaching strategies 

  • Role modeling 

  • Discussion 

  • Role playing 

  • Simulation gaming/virtual reality 

• Examples of desired outcomes related to a behavior change 

  • Expresses positive feeling, attitudes, values towards changing the behavior 

Not measurable: Dan will demonstrate the importance of low salt intake

Measurable: Dan will verbalize the importance of low salt intake by discussing the impact this will have on his health

• Affective 

Not measurable: Dan will know how to determine a serving

Measurable: Dan will demonstrate correct measurement of a one serving portion

• Psychomotor 

Not measurable: Dan well understand the correct food choices for following a low salt diet

Measurable: Dan well correctly select low salt foods from the options provided

• Cognitive

Questions to consider for type of learning strategies 

• What are some basic considerations for selecting teaching methods for health education programs?

• How does the nurse, as an instructor, establish and maintain a learning climate?

• What actions can the nurse perform to increase the effectiveness of the learning methods?

• How can the use of technology (virtual reality, simulation, apps) support the learning experience?

• What methods tend to promote behaviour change?

Other considerations

• Use methods that promote self-directed learning. (An active participant usually learns more)

• Factor in the characteristics of the population (developmental stage, age, and knowledge of the topic and learning styles)

• Select teaching methods that best support the goals of the educational program 

• Vary the teaching methods in a given session 

• Be sensitive to the energy level and anxiety of the audience 

Learning climate

• Create a sense of preparedness and organization 

• Anticipate the needs of the group and communicate information about the schedule and the facilities 

• Assess individual and group learning needs, possibly through questions and dialogue 

• Maintain a high level of motivation, a sense of individualized attention, and a progression 

• Work with the group to maintain the learning climate 

Teaching and organizing skills

• Seek self-assessment opportunities 

• Identify, list, nd prioritize learning need 

• Begin to identify the resources that are available for reading, instructor training, and practice training 

• Select the target population and the general topic 

• Draft an initial set of learning skills

• Work through the steps of the teaching - learning process, including the development of a teaching plan 

• Identify other people or a project team to help 

Evaluating the teaching process

• Written or oral testing, demonstrations, observations, self reports, and self monitoring 

• Obtaining feedback about teaching performance into the teaching plan 

• Confidential, end - of program questionnaires are the usual method for obtaining written feedback 

• Verbal or nonverbal feedback