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Sexual health education for people with mental health problems: what can we learn from the literature?

Research into sexual risk behaviour among people with 'severe' mental health problems suggested that they are likely to engage in high-risk sexual behaviour, for a number of reasons, putting them at risk of sexually transmitted diseases. The aim of this review is to describe approaches, content and outcomes of sexual health education programmes, developed and implemented for people with mental health problems. A literature review from 1980 to 2005 was carried out using the electronic databases CINAHL, PsycINFO, British Nursing Index, Pubmed and Medline, and the Cochrane library was also searched. The literature search was confined to papers written in English. The keywords 'sexuality', 'sexual health education', 'sexual health promotion', 'HIV', 'sexually transmitted disease' were combined with 'mental illness', 'chronic mental illness''severe mental illness''persistent mental illness''psychiatry', 'mental disorder', 'education interventions' and 'evaluation'. A vast amount of literature was recovered on sexual risk behaviour in people with severe mental health problems, and sexual dysfunction as a result of prescribed medication. As the focus of the review was on sexual health education, this literature was omitted. Although the literature on sexual health education for people experiencing mental health problems was sparse, 14 studies were located that either described or evaluated sexual health education programmes. Most sex education programmes focused on topics such as HIV and other sexually transmitted diseases, negotiating safe sex and skill development in condom use. Findings suggested that the people who attended benefited from sexual health education programmes, facilitated in a sensitive and supportive manner. Education tended to produce a reduction in sexual risk behaviour as opposed to complete cessation. Nevertheless, it is appropriate to consider integrating such education with service provision. The results of the review provide guidance to service providers and mental health nurses wishing to develop and evaluate sexual health education programmes for service users. Areas for future research are also identified.

Attitude to Health↗

How is oral health education conducted in Finnish health centers?

The oral health education (OHE) given in Finnish health centers is mostly implemented by dental assistants and hygienists. However, there is no exact information concerning the distribution of OHE work and the working methods among individual health educators. The aims of this study were to assess 1) the time used for OHE by the dental professionals who bear most of the responsibility for OHE in health centers, and to evaluate 2) the collaboration between OH-educators and the parents of schoolchildren, school personnel and the other health care personnel and 3) the sources of the OHE knowledge and skills of these OH-educators and their methods according to their work load. The data for this study were collected from 323 OH-educators. About one fourth (28%) of the OH-educators used 40% or more of their working time for group OHE and one third (33%) used 40% or more of their time for individual OHE. These workers were considered to be full-time OH-educators. The mean age of the OH-educators was 36 yr. The mean length of the OHE career was 8 yr. The most common OHE methods were a usual type of school lesson or a lesson in which the audience was questioned. Slides, models, transparencies and leaflets were the most general visual aids used.

Adolescent↗

Educating health professionals to respond to bioterrorism.

In September 2003, a consortium of bioterrorism and health education experts from the University of Louisville, the University of Kentucky, the Kentucky Department for Public Health, and the Louisville Metro Health Department received funding from the Health Resources and Services Administration (HRSA) to develop a broadly based bioterrorism education program for health professionals in the Commonwealth of Kentucky and the surrounding region. This grant will fund a series of presentations tailored to the needs of professionals in medicine, dentistry, public health, nursing, behavioral medicine, allied health, pharmacy, veterinary medicine, and agriculture, providing coordinated training both on site and through distance learning technology. This article outlines the major grant-funded activities envisioned for the grant years 2003 through 2005, focusing on the use of standardized patients and computerized biosimulators, the transdisciplinary partnerships of the universities involved, and the essential collaboration provided by the state and local health departments.

Bioterrorism↗

An assessment of the Cardiovascular Health Education Program in primary health care.

Primary health care is an effective means of improving health for all while at the same time containing rising health care costs. In an effort to improve the health of one community, the Cardiovascular Health Education Program (CHEP) was implemented in a study of 44 eighth-grade adolescents. The purpose of this study was to assess the influence of the CHEP on adolescents' cardiovascular health knowledge. It was found that participants' knowledge improved significantly, whereas a control group showed no comparable improvement. This study showed that community-based health education programs for targeted populations can influence health knowledge.

Adolescent↗

[Health education in schools for adults: by a teacher or health education lecture?].

OBJECTIVE: To compare the results of two ways of teaching the rational use of medicines to students of centres of permanent education of adults (CPEA): one taught by the normal teachers (after training by health personnel) and one through a lecture given by the health staff. DESIGN: Intervention study without randomised distribution and with a control group. SETTING: Five CPEA in an urban centre. PARTICIPANTS: 385 students and 15 CPEA teachers. INTERVENTIONS: Three groups: a) "teachers" group: consisting of students who received education on medicines in the class-room through their teachers, who had been previously trained by health personnel; b) "lecture" group: students who had received a health education lecture on medicines given by health staff; c) non-intervention group. All three groups were administered a questionnaire before and after the intervention. Both questionnaires were paired. MEASUREMENTS AND MAIN RESULTS: 248 people completed the first questionnaire and 149 the second. Significant gains in knowledge were only found in the teachers intervention group (p < 0.01; 7.8% increase in score). Dividing the students into terciles made these gains significantly greater (11.7%) in the students of the teachers group who in the first questionnaire had intermediate scores than in the students in the other groups who had intermediate scores. CONCLUSIONS: Intervention with teachers seems more effective than either a health education lecture or no intervention, especially in the improvement in knowledge of students who already had beforehand intermediate knowledge.

Adult↗

Impact of health education program about reproductive health on knowledge and attitude of female Alexandria University students.

In Egypt, adolescents don't have enough and/or correct knowledge regarding reproductive health. Health education interventions are widely seen as the most appropriate strategy for promoting young people's sexual health. The aim of the present work was to assess the impact of a short-term health education program about reproductive health on knowledge and attitude of female Alexandria university students. Quasi-experimental study (pre-post testing control group) was carried out among 682 female university students living in the university hostels, 354 students represented the intervention group (Ezbet-Saad hostel) who received the program and 328 students constituted the control group (El-Shatby hostel). The study revealed that no one had satisfactory knowledge level while 61.7 % and 38.3% respectively had fair and poor levels. The low knowledge level was more evident regarding the questions about: the meaning of the term 'reproductive health' (only 5.1% gave correct complete answer), the benefits of premarital examination (only 37.9% reported complete answer), the investigations done for the pregnant woman (only 28.3% gave complete answer) the benefits of breast feeding (only 8.2% reported complete answer), methods of family planning (only 36.4% gave complete answer), side effects of female genital mutilation (only 4% reported complete answer), sexually transmitted diseases and methods of protection (only 11.9% and 3.9% reported complete answer). It was evident that 32.6% had an overall positive attitude level, 46.3% were in the neutral level and 21.1% had a negative level. It was also found that students of highly or moderately educated mothers and of high social class reported significantly higher knowledge score about premarital examination, age of marriage and breast-feeding than those of non-educated mothers and of low social class. After the intervention program there was a significant improvement in the majority of knowledge questions from pre to post test in the intervention group and no absolute changes were detected in the control group. The highest percentage of gain scores (33.3%) was detected for knowledge about the term 'reproductive health' and female genital mutilation. A significant gain score of 25% was observed for the knowledge about sexually transmitted diseases. Also there was a gain of 20% in the median score concerning the knowledge about breast feeding and family planning. A significant shift towards a positive attitude was found among the intervention group.

Adolescent↗

The impact of including husbands in antenatal health education services on maternal health practices in urban Nepal: results from a randomized controlled trial.

Observational studies suggest that including men in reproductive health interventions can enhance positive health outcomes. A randomized controlled trial was designed to test the impact of involving male partners in antenatal health education on maternal health care utilization and birth preparedness in urban Nepal. In total, 442 women seeking antenatal services during second trimester of pregnancy were randomized into three groups: women who received education with their husbands, women who received education alone and women who received no education. The education intervention consisted of two 35-min health education sessions. Women were followed until after delivery. Women who received education with husbands were more likely to attend a post-partum visit than women who received education alone [RR = 1.25, 95% CI = (1.01, 1.54)] or no education [RR = 1.29, 95% CI = (1.04, 1.60)]. Women who received education with their husbands were also nearly twice as likely as control group women to report making >3 birth preparations [RR = 1.99, 95% CI = (1.10, 3.59)]. Study groups were similar with respect to attending the recommended number of antenatal care checkups, delivering in a health institution or having a skilled provider at birth. These data provide evidence that educating pregnant women and their male partners yields a greater net impact on maternal health behaviors compared with educating women alone.

Adult↗

A profile of public health educators in North Carolina's local health departments.

The purpose of this study was to provide a profile of the public health education workforce in North Carolina. A survey was administered to all practicing health educators at local health departments (LHDs) in North Carolina. The study specifically attempted to answer four questions: (1) Who functions as health educators in LHDs in North Carolina? (2) What is the educational background and professional training of North Carolina LHD health educators? (3) What are the characteristics of health educators' positions in North Carolina? and (4) How do these characteristics of health educators (demographics and education) as well as their titles, job responsibilities, and supervisory relationships differ according to the size of the LHD? The study showed that most public health educators in North Carolina are white females; most do not have Certified Health Education Specialist certification; that younger health educators are more likely to have health education degrees; and that almost two thirds of public health educators have administrative responsibilities.

Adult↗

[Students awareness of health teaching: evaluation of "health education" course and the occupational health nursing practice].

The "health education" course is an important part of the baccalaureate curriculum in nursing. It is essential to teach students effective health education in a client oriented way. In order to improve the quality and content of this course, we extracted students descriptions from records of 44 students who had carried out group health education during nursing practice for the occupational health nursing course. We then analyzed students written sentences on their views concerning health teaching. After sentence analysis, we categorized these concepts into groups and titled them. The results of clarification of categories showed that the most common student awareness was in regard to technical and instructional skills, such as precise and suitable language selection for laymen, and utilization of teaching devices or mediums, during implementation of health teaching(43.6%). Secondly, assessment of health needs for a certain working population(10.3%), and effective teaching types such as instructional participant volunteers and full participation(9.2%) were deemed important. Thirdly, identification of the role of the occupational nurse(7.7%), and lastly the necessity of evaluation(2.3%) were considered necessary. Over all, in this study we found that students were most concerned about the instructional skills during the presentation of health education. Also, these results suggest that development of contents in the "health education" course to reinforce students assessment and evaluative abilities should be incorporated into the course. Furthermore, faculties who teach a "health education" course should provide a large variety of teaching materials and creative instructional methods for the students.

Awareness↗

Assessing parents as health educators.

Parental health knowledge and beliefs are critical determinants in decisions concerning health care matters of children. This article describes a data collection instrument based on Orem's Self-Care Theory that can predict the potential for health education in the home.

Adult↗

Evaluation of the Master's in Genomic Medicine framework: A national, multiprofessional program to educate health care professionals in NHS England.

PURPOSE: Genomic medicine is revolutionizing health care but requires health care professionals to update their understanding of genomics and its application to clinical practice for successful implementation. To meet this need, Health Education England developed the Master's in Genomic Medicine, a national multiprofessional program to increase genomic literacy in the National Health Service workforce. This study summarizes an evaluation of the program, which will inform its future development. METHODS: Underpinned by Moore's evaluation framework, a mixed methods approach was used to characterize (1) learner demographics, (2) perceptions of the program, (3) knowledge and/or qualifications achieved, and (4) the outcome(s) for practice in the workplace. RESULTS: Learners were a diverse cohort of health care professionals, including doctors, health care scientists, nurses and midwives. Participant satisfaction was high for all elements of the program, including the curriculum, learning environment(s), and multiprofessional cohort(s), despite the challenges of engaging working professionals in part-time learning. Both learners and their managers reported enhanced genomic practice after completion of their studies. CONCLUSION: The Master's in Genomic Medicine program is an effective approach to professional education in genomic medicine. This broad multiprofessional learning complements training aimed at specific groups of health care professionals.

Humans↗

Effect of dental health education on the oral health status of a rural child population by involving target groups.

India, a developing country faces many challenges in rendering oral health needs. The majority of Indian population resides in rural areas, of which more than 40% constitute children. These children cannot avail dental facilities due to inaccessibility, financial constraints and stagnation of public dental healthcare services. This entails the health professional to adopt a more practical approach to achieve primary prevention of oral diseases. The most viable solution seems to be dental health education. Documented evidence shows that teachers and parents can augment dental health behaviour. With this background, it was decided to target children in a rural area for comparing the effect of education on children alone, children coupled with teachers and children with the involvement of their parents. An interventional study of 4 months duration was conducted on 430 children, 7 teachers and 100 parents. The parents were educated at home. Clinical oral health status was assessed prior to the delivery of dental health education and also following the intervention. Results showed that the dental health scores improved best in the group of children involving the teachers. It was concluded that teachers could be targeted in order to enhance the effect of dental health education campaigns on children.

Analysis of Variance↗

A green health education approach to health promoting schools.

Since the Education Commission of the Hong Kong Special Administrative Region had proposed the educational reform in 2000, there is a new direction for school curriculum development. Lok Wah Catholic Primary School was one of the schools taking the health promoting school approach for educational reform. This paper aims to share information on how the School implemented the "Green Health Education Approach" to create a healthy learning environment for students.

Curriculum↗