NSCH 111 Study Unit 6: Health Education in the Community

Health Education in the Community

6.3: Nursing Process and Dimensions Model

• Applies to health education.
• Compiled by Mrs. Petro Benadé.

Learning Outcomes

• Understand and apply the nursing process and the dimensions model of community health nursing in health education.

Needs Assessment

• A planned process that identifies the needs of an individual or group. (Clark, 2008: 264)

Target Group

• The individuals to whom an intervention program is aimed at and that would benefit from the intervention (Clark, 1999:146).
  • E.g., The Syferfontein community consisting of women, men, and children.

Planning (as related to health education)

• Planning in the context of health education involves making decisions regarding:
  • What topic to address
  • What problems to attack
  • Where to direct time and resources (Butler, 2001, p.259 as cited by Clark, 2008:267)

Goals

• The broad purpose of the health education encounter (Clark, 2008:267)

Objectives

• The specific outcomes that need to be achieved as a result of a health education program (Clark, 2008:268)

Steps in the Health Education Process: Dimensions Model

• Use the Nursing Process and the Dimensions Model to design the health education:
  • Use the Dimensions of Health to assess:
    • The audience
    • Their health education needs
    • The learning environment (Clark, 2008)
• Diagnose their learning needs
• Use the Dimensions of Healthcare to:
  • Plan
  • Implement
  • Evaluate
• Use the Dimensions of Nursing during the whole process (Clark, 2008)

Assessment

• Assessment of the audience, their health education needs, and the learning environment using the dimensions of health in the dimensions model (Clark, 2008:264-267+272) (Clark, 1999:172-175)

Assessing Health Education Needs

• Assessment of the health education needs according to the 6 dimensions of health:
  • Biophysical considerations
  • Psychological considerations
  • Physical environmental considerations
  • Socio-cultural considerations
  • Behavioral considerations
  • Health system considerations
  • SELF STUDY!!! (Clark, 2008:264 + 266-268) GEFOKUSDE ASSESSERING NB! Bladsy 268

Dimensions of Health

Biophysical Considerations

• Age composition of the target audience
• Learning needs arising from age and developmental level of audience
• Effect of developmental level of audience on ability to learn or teaching strategies
• Effect of physical health problems in the population on the need for health education or hindrance of learning (Clark, 2008:73; 268)

Psychological Considerations

• Awareness of the target population of the need for health education
• Level of motivation to learn
• Effect of population attitudes toward health and health behaviors on learning ability
• Levels of stress or anxiety of target audience interfering with learning (Clark, 2008:73; 268)

Physical Environmental Considerations

• Conditions in the physical environment giving rise to health education needs
• Effects of the environment on learning (Clark, 2008:73; 268)

Sociocultural Considerations

• Effects of learners’ peers on motivation to learn
• Current education level of learners
• Prior exposure to health information
• Primary language spoken by the target audience
• Cultural beliefs and practices influencing learning
• Influence of occupations of group members on need for health education
• Factors in the social situation influencing health education
• Effect of these facets on the health education situation (Clark, 2008:73; 268)

Behavioral Considerations

• Common health behaviors in the population that give rise to the need for health education (Clark, 2008:73; 268)

Health System Considerations

• Emphasis of health education by local healthcare providers
• Access to healthcare services/education
• Need for education regarding the use of healthcare services
• Need for health education caused by healthcare recommendations
• Influence of elements of the healthcare regimen on learning abilities (e.g., medications)
• Influence of attitudes toward healthcare services and providers on the ability to learn (Clark, 2008:73; 268)

Diagnostic Reasoning in Health Education

• Example of a diagnosis
  • "Need for education regarding effective modes of discipline appropriate to child’s age due to limited knowledge of child development, poor parental role models, and poor stress management skills." (Clark, 1999:175)

Planning Health-Education Programs

• Prioritizing learning needs
• Developing goals and objectives
• Selecting and sequencing content
• Selecting teaching strategies
• Preparation of materials
• Planning evaluation (Clark, 1999:176-180)
• Also, see for self-study:
  • Language and literacy in health education
  • The internet in health education (Clark, 2008:267-270)
  • Using media in health education and health promotion (Clark, 2015:270-272)

Prioritizing Learning Needs

• Determine the risk factors in the population and the benefits if they can be changed.
• Decide which risk factor must get attention first.
• In community nursing, the first decision may be health education that addresses the most important problem. (Clark, 2008:267)
• Community members can help determine priorities. (Clark, 2015:271)

Developing Goals and Objectives

• The broad goal of the health education encounter is specified
  • Program goals
    • Purpose of the whole health education program
      • E.g., Prevention of obesity in school-aged children
  • Educational goals
    • Learning outcomes that are expected for the audience
      • E.g., Parents need to obtain more knowledge regarding child nutrition (Clark, 2008:267-268)

Objectives

• Specific outcomes that need to be achieved as a result of the health education program

  • Program objective
    • The incidence (number of new cases) of childhood obesity will drop by 50% in 2 years
  • Educational objective
    • Parents can indicate the number of servings of each food group needed by school-aged children on the food guide pyramid (Clark, 2008:268)

• Objectives need to be stated in measurable terms to determine if the expected outcomes have been reached.

• Outcomes need to be specific in order for them to be evaluated.

  • E.g., A drop of 50% in the incidence of childhood obesity, including a timeframe of 2 years, for expected achievement. (Clark, 2008:268)

Selecting and Sequencing Content

• The nurse usually has a greater knowledge of a specific topic.
• Need to select and organize content to fit the client’s needs.
• New learning must be based on previous learning.
• Sequenced from:
  • Simple to complex
  • Most important to least important
  • Familiar to less familiar (Clark, 1999:178)

Selecting Teaching Strategies

• Characteristics of the audience
• Content and objectives
• Program budget
• Time available
• Cultural appropriateness
• Environment (Clark, 2008:268)

Preparation of Material

• Needs to be appropriate for the audience.
  • E.g., For a group of young children, a coloring book might be more effective than a “PowerPoint Presentation” (Clark, 1999:178)
• Take language and literacy into account
  • Self-study: (Clark, 2008:270, Table 11-5)

Planning Evaluation

• Plan for the development of criteria to measure the effectiveness of the health education session, e.g., evaluation.
• Evaluation is done to determine if the audience did learn something.
  • E.g., asking questions. (Clarke, 1999:179)

Implementation of the Health-Education Session

• Speak in the patients’ language
• Do not use difficult medical terms
• Keep message short
• Key points
• Verbal headings
• Repetition (Clark, 1999:180)
• Communication clear
• Relevant information
• Structured information (VPGR 111, PGCE, Study guide, 2014:22)

Implementation

• Focus event
  • Gain attention of the audience
  • Focus attention on the material to be presented
  • E.g., slides child abuse
• Presentation of content
  • Lesson presented as planned
  • Formative checks
  • Client participation e.g., group discussion, role-playing, etc. (Clark, 1999:180)
• Summary of the session
  • Reinforces pertinent points
  • Recaps and highlights the major concepts covered
  • Synthesizes content in a few major themes (Clark, 1999:180)

Evaluating Health Promotion Programs

• Diagnostic evaluation
  • Accuracy of needs assessment is assessed
• Formative evaluation
  • The way the program was carried out is examined
• Summative evaluation
  • The focus may be on the program outcome, impact, or both (Clarke, 2008:271)

Self Study

• Plan a health education program for a rural community
  • (Clark, 2015: 280-281)
  • (Clark, 2008: 272-273))
  • (Clark, 1999:181-182)
  • (NSFP 111 Section B: Community Health)
  • Health Education PowerPoint 2020)

Elements of a Community Health Education Program

• Assessment:
  • Biophysical factors
  • Psychological factors
  • Physical environmental factors
  • Sociocultural factors
  • Behavioral factors
  • Health system factors
• Purpose/Goal
• Levels of prevention
• Objectives
• Content
• Teaching strategies/materials
• Evaluation (Clark, 2008:272-273)

Scenario

• The community of Syferfontein lives on a farm.
• There is no tap water and no toilets.
• The community consists of women, men, and children.
• The men work on the farm, and the women stay at home to look after the children.
• The only place available to give health education is a small room with a few chairs.
• During winter, it is very cold, and during summer, it is very hot in the room.
• The refuse lies around the houses, and there are no vegetable gardens.
• The community members live far from town, and they are very poor.

Assignment

• Assess the health education needs of the community according to the six dimensions of health.
• Formulate an educational diagnosis.
• Plan a health education program for the Syferfontein community.
• Implement a health education program for the Syferfontein community.
• Evaluate your health education program.

Reference List

• Clark, M.J. 1999. Nursing in the community: Dimensions of community health nursing. 3rd edition. Stamford, Connecticut: Appleton & Lange.
• Clark, M.J. 2008. Community Health Nursing: advocacy for population health. 5th ed. New Jersey: Pearson Education
• Clark, M.J. 2015. Population and Community Health Nursing. 6th ed. New Jersey: Pearson Education.
• Watson, M.J. 2014. Community Nursing Science Processes. Potchefstroom: NWU, Potchefstroom Campus. (Study guide VPGR 111).