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Are basic assumptions we hold about health education defensible?

Underlying numerous programs designed to promote healthfulness are several implicit and/or overlooked assumptions. These suppositions are considered to be "understood." However, more often they lack validation in an empirical sense. The article is intended to prompt a systematic appraisal of certain presumptions about health, health education and health educators.

Health↗

Primary health care, policy makers and health education: some challenging goals.

A challenge to politicains and health administrators everywhere, and therefore to health education, is how to achieve a more equitable distribution of health care to the people. A new approach that may well be the answer is the use of primary health care, which is concerned with measures that will provide simple and effective health care to all people. The priniciples on which primary health care is based have much in common with those of health education, as spelled out over the past 20 years by WHO expert committees, namely: involving people in a working partnership respecting their values and beliefs, placing reliance on indigenous practitioners, etc. In both cases, "the focus is on people and action" and the primary health care context offers a challenging opportunity for health education to make a major contribution towards a fairer distribution of health services. Another area where health education has a particular challenge to meet concerns the education of politicians at all levels: health educators must do all they can to influence health and health-related policy away from those determined solely by political expediency and towards policies that benefit the people. They must also help bridge the gap between "deciding politicians" and the "consuming citizen" to help ensure that the decisions of the former meet the needs of the latter.

Health Education↗

[Rational structures in health education models: basics and systematization].

The different Health Education (HE) models appeared in the scientific literature are analyzed, trying to eliminate the confusion produced by its great diversity, applying a general and systematic point of view. Due to the relevance of that topic in the activities of Health Promotion in Primary Health Care it is urgent a deep reappraisal due the heterogeneity of scientific papers dealing with that topic. The curriculum, as the confluence of thought and action in Health Education, is the basic concept thanks to which it is possible to integrate both scientific logic, the biological one and that pertaining to the social sciences. Of particular importance have been the different paradigms that have emerged in the field of HE from the beginning of the present century: a first generation with a "normative" point of view, a second one orientated from positivistic bases, and a third generation adopting an hermeneutic and critic nature. This third generation of paradigms in HE has taken distances from the behaviouristic and cognitive perspectives being more critical and participative. The principal scientific contributors in the field of HE, internationals as well as spaniards are studied and classified. The main conclusions obtained from this Health Education paradigm controversy are referred to both aspects: 1) planning, programming and evaluating activities, and 2) models, qualitative and quantitative methodologies. Emphasis is given to the need of including Community Participation in all phases of the process in critic methodologies of HE. It is postulated the critic paradigm as the only one able to integrate the rest of the scientific approaches in Health Education.

Community Health Centers↗

Teaching children about mental health and illness: a school nurse health education program.

A mental health education program designed by school nurses for children ages 10- 12 was developed in 2000-2001 and expanded with broader distribution in 2004-2005. Six classroom sessions, each 45 minutes in length, provided information and activities to increase children's awareness of mental health and illness. Education program content included facts about the brain's connection to mental health, information about healthy ways to manage stress, resources and activities to promote mental health, common mental health problems experienced by children, and how to seek help for mental health problems. Classes included a combination of didactic presentation and open discussion, encouraging students to ask questions and allowing the school nurse to correct misinformation. Analysis of pre- and posttests from 370 elementary and middle school students revealed statistically significant improvements in their knowledge of mental health and mental illness.

Adaptation, Psychological↗

[Promoting health instead of health education].

The idea of health education--meaning experts telling laymen how to setup a healthy behaviour by applying educational tricks--is an illusion. Humans don't act as they should by following the ideas of public health scientists, not even after an intensive educational training. They aren't trivial machines. Their way of acting ist not predeterminable. A change of strategy from health promotion to changing the attitude to health promotion to random circumstances of living has been of limited success. Changing these circumstances (top down) improves only a part of health influencing factors. It is impossible to exclude that by changing these factors others are made worse. But by ethic standards we are titled to check decisions relating to living conditions in respect of their health relevance. Therefore, health promotion meaning the promotion of more self-determination of one's own health is inevitable if a sustainable success is wanted. The request for a short-time measure of success is understandable from an economic point of view but it is not adequate. In the long run this would lead to trivilaesation++ of matters that are not trivial.

Forecasting↗

Health education via interactive television.

Providing health education in rural areas is a challenge because of the time and cost involved in travel to serve small groups of clients in their own towns. Baccalaureate nursing students provided health education to faculty and staff members in five rural high schools simultaneously through the use of interactive television.

Education, Nursing, Baccalaureate↗

Voices from the field--a qualitative analysis of classroom, school, district, and state health education policies and programs.

This study provides a qualitative analysis of responses from classroom-, school-, district-, and state-level educators and administrators to open-ended questions about school health education. These questions were posed as part of the School Health Policies and Programs Study (SHPPS), conducted by the Centers for Disease Control and Prevention in 1994, and elicited a range of responses about the status of school health education programs and factors that facilitated and hindered the delivery of such programs. To improve school health education in the United States, respondents cited the need to increase the value and priority of health education in the school curriculum and advocated for 1) professional preparation in health education for persons teaching health-related courses, 2) health education course curricula to address important and timely issues, 3) student testing in health education, 4) improved resources and support for health education, and 5) increased communication and collaboration within their schools and communities related to health education.

Centers for Disease Control and Prevention, U.S.↗

[Health in today's media society. Institutional health education and television entertainment].

The article sketches concepts of entertaining health education programmes on television as discussed in the new sub-discipline of health communication in Germany and describes some examples and aspects of cooperation between the Federal Center for Health Education (BZgA/FCHE) Cologne as an institutional health education agency and German television partners. Specific chances and problems of entertaining forms of mass media health education on television are discussed. Finally, perspectives for institutional health education in relation to television are discussed.

Forecasting↗

HealthScope: a model for a low cost health education program using commercial television.

HealthScope is a health education based on the Health Belief Model that uses television and print materials. It was designed for a number of agendas--(a) a desire by health educators to provide health information to a broad audience at a reasonable cost (b) a desire by the local medical association to promote its role in prevention and primary care, and (c) a desire by commercial television to expand its coverage of local health issues in a cost-effective way. In its summer series, HealthScope included 10 weekly television programs that focused on various aspects of disease prevention and health promotion and answered viewers' questions on the air. Each program was followed by a bank of physicians answering questions on the telephone for 90 minutes. Corresponding fact sheets were distributed through a local pharmacy chain. A "healthy weekend" sweepstakes contest also was held. Intermediate outcome measures indicated that HealthScope had a broad reach and stimulated viewers to seek additional information about health. At the same time, the program generated revenue for the commercial television station.

Adolescent↗

[Problems and their frequency, and emotional disturbances and needs among nurses providing sexual health education].

This study investigated the problems encountered by nurses delivering sexual health education, the frequency of occurrence of such problems, the types of emotional disturbances experienced by such nurses, and the needs of such nurses. Ninety urology nurses from six hospitals in northern Taiwan participated in this cross-sectional survey by completing a Problems and Needs in Sexual Health Education (PNSHE) questionnaire. Factor analysis showed that the PNSHE consisted of three dimensions: patient's response, environmental interaction, and nurses' self-preparation. Among 26 items listed as "difficult," nurses faced 23 (89%), at frequencies ranging from "half the time" to "often". They faced "moderate" degrees of emotional disturbance and "moderate" needs for assistance. Over all, Environmental interaction was the dimension which arose most frequently, caused the greatest degree of disturbance and prompted the greatest need for assistance among nurses. Nurses were frequently disturbed by the problem of "evaluating effects of sexual health education," and most needed assistance for "lacking suitable materials." Stepwise multiple regressions demonstrated that ability in providing sexual health education, years of nursing experience, and proactiveness in providing sexual health education were significant variables related to the frequency of the problems, accounting for 21% of the variance. Ability in providing sexual health education was significantly related to the degree of emotional disturbance, accounting for 6% of the variance. Ability in providing sexual health education and years of nursing experience were related to nurses' needs while providing sexual health education, accounting for 6% of the variance. The findings of this study provide information of problems and needs encountered by nurses while delivering sexual health education, and should also assist senior nurses in identifying educational courses and resources to develop competency in providing sexual education.

Affective Symptoms↗

[A nationwide survey on current conditions of school health education].

PURPOSE: The purpose of this study was to analyze and assess the current situation of Korea's school health education program and to establish measures to efficiently carry out school health education in Korea. METHOD: The survey was conducted through the internet with the health educators of elementary, middle, and high schools nationwide to assess the current condition of school health education programs, and 2,459 samples were collected which accounted for 23.4% of the total respondents. RESULTS: According to school health educators on the enforcement of health education, the higher the education became, the less the health education was enforced. The enforcement rate was 96.9% in elementary schools, 76.7% in middle schools, and 67.3% in high schools. The major reasons were found as difficulty in securing class time (54.5%) and other excessive workloads (20.9%). As a result of the health education awareness survey, over 99% answered that health education is needed, over 80% answered that the education requires independent health textbooks, and over 95% answered that health educators are suitable for the person in charge of the education. CONCLUSION: This study will be a useful in establishing a detailed policy on enhancing school health education in the future.

Adolescent↗

[Health education and tuberculosis control around 1900].

UNLABELLED: Health education nowadays is considered a nursing task. Traditionally medical doctors claimed that this intervention belonged to their field of work. This article investigates the role of German nurses in health education around 1900. The problem of tuberculosis control serves as an example. For this purpose the academic library for the history of science at the Humboldt University, Berlin was searched for relevant sources. From the texts found, statements about health education and nursing tasks were compared. RESULTS: For the period around 1900 two different strategies of control can be identified. The sanatorium, which beside its therapeutic function was conceived as an educational institute for personal hygiene, occupied the central position. Under the guidance of medical doctors a lasting attitude change of patients should occur. Contemporary criticism, however, doubted the concept's efficiency. As an alternative, a local attendance program by means of welfare offices was suggested. Often, these institutions provided the sole practicable way of action. Here, the nursing staff acted more independently in comparison to the sanatorium under medical direction. Health education played a key role in the work of the welfare nurses.

Communicable Disease Control↗

Health education in Cuba: a preface.

Critics of health education policy in the United States fault it for ignoring the unequal ability of Americans to adopt more healthy behavior and for underestimating the social, economic, and political causes of disease. Many critics hypothesize that health education in a less bourgeois society would be more equitable and less individualistic. This article tests that hypothesis by analyzing the current Cuban health education program aimed at the reduction of chronic diseases. It argues that while the Cuban program appears to be every bit as individualistic as the North American program, theirs may not be comparable to ours because Cubans are less likely than Americans to reify the state. At least among supporters of the revolution, Cubans do not automatically make a conceptual distinction between the individual and the society. Discussions about responsibility for disease prevention take on new meaning in this light.

Accidents, Traffic↗