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How effective are health education programmes--resistance, reactance, rationality and risk? Recommendations for effective practice.

Behavioural-change-related health education programmes represent a mainstay of health care activity. Where adopted, however, the theoretical and practical constructs and constraints are not always considered. The failure of many health education programmes to achieve their intended life-style-related behavioural-change outcomes is often directly related to the complexity of the task itself. Changing a client's health behaviour is notoriously difficult and requires concerted and systematic activities to ensure any measure of success. This article draws upon existing literature to develop a critical theoretical and practical perspective for health education practice in nursing. It aims to explore the underpinning theoretical considerations for undertaking behavioural-change health education programmes. This article also proposes specific recommendations for nurse's current and future health education practice, as a means for facilitating a more structured approach to health education programme planning and evaluation.

Health Behavior↗

Program planning in health education.

This selected review of the health education literature suggests that progress has been made in developing extensive conceptual frameworks to examine the interrelationships of complex forces which influence health related behaviors. However, the reviewer found very little applied research in which these concepts are translated into effective and efficient intervention strategies within ongoing programs. The author states that an improvement in the state of the art in health education practice should emerge from seven important developments which she identifies.

Evaluation Studies as Topic↗

[Health care for middle age: health education strategies].

Middle age is an important period for confronting physical and psychological changes, and a crucial time for building positive health habits for the elderly stage of life. In addition, middle-aged adults must adapt their physical and psychological changes with their social roles. The purpose of this article is to highlight the importance of health education and health promotion for middle-aged adults, and to describe how the application of health education and planning through health education strategies can improve the health status of this population.

Delivery of Health Care↗

Policy tools for building health education and preventive counseling into managed care.

CONTENT: Six policy tools for building health education and preventive counseling into managed care are presented, and the opportunities and barriers to implementing each are described based largely on managed care plans operating in California in 1998. The six policy tools include (1) covering health education and preventive counseling as defined benefits, (2) increasing access to and use of health promotion programs, (3) incorporating health education into disease-management programs, (4) defining quality performance measures for health education and preventive counseling, (5) defining performance targets and guarantees for health education and preventive counseling to hold health plans accountable for providing these services, and (6) building collaboration between public health agencies and managed care on public health education and health promotion. For each of these, the policy option is described, examples of current practice are provided, and the problems and limitations associated with each are discussed.

Adult↗

Health education: a boon to humanity or a fantasy and fraud?

The health education profession in the United States has been influenced by three major forces in recent years: sociomedical phenomena resulting in a public demand for health education, disease specificity of the practice of health education, and the process of professional credentialing. While these three forces are looked upon by many as beneficial to the profession, they also pose significant threats to the viability of the profession. Health educators must deal with these threats if the health education profession is to significantly benefit humanity. Otherwise, the profession may be ultimately perceived as a fantasy and fraud.

Credentialing↗

An interdisciplinary educational approach to assessing the health care and health educational needs of the elderly in a South Carolina community.

This article describes work from an allied health project grant that resulted in an interdisciplinary geriatric educational experience for health professions faculty and students (health information administration, occupational therapy, physical therapy, and health professions education) at an academic health sciences center. The educational experience centered on the process of designing, administering, and analyzing the results of a comprehensive needs assessment for clients attending a senior citizen center. This process enabled faculty and students to integrate education, service, and research activities into their curricula, and to work as an interdisciplinary team in assessing the health care needs of elderly adults in the community.

Adult↗

Society for Public Health Education: survey of membership.

The Society for Public Health Education, Inc. (SOPHE), through the Research and Evaluation Committee (REC) of the Tennessee chapter has surveyed its membership to determine characteristics of members, members' opinions of the organization and the benefits derived, usefulness of SOPHE publications, and the most important health education issues and goals. Survey results provide an employment profile of the membership, and indicate the membership benefits which are most valued; they also suggest that the organization's goals and its activities be expanded in scope to include, in addition to other areas, greater attention to health education practice, to planning legislation, to funding, and to cooperation with the American Public Health Association in the general promotion of health education. REC presents recommendations based on these findings.

Employment↗

Historical and current policy efforts to eliminate racial and ethnic health disparities in the United States: future opportunities for public health education research.

In the summer of 2005, the Society for Public Health Education convened a meeting, Health Disparities and Social Inequities, with the task of setting the minority health disparities research agenda for public health educators. The article provides a history of minority health efforts beginning with the Negro Health Improvement Week in 1915 and an overview of National Institutes of Health's (NIH) current 5-year strategic research plan to eliminate health disparities. The plan's goals represent a significant investment in minority health research and the emergence of NIH as the leading federal agency funding health disparity research. Understanding the history of minority health efforts and current health disparity research offers a perspective that will help guide public health educators in reaching the Healthy People 2010 goal of eliminating racial and ethnic health disparities.

Black or African American↗

Emerging trends in professional preparation: implications for the future of health education.

During the 1982-1983 academic year, 115 academic institutions were surveyed concerning trends in professional preparation in Health Education. Findings indicate that 13,225 students are currently majoring in Health Education with 4,810 specializing in school health education and 8,415 specializing in public health education. A marked increase in the number of students specializing in public health education within the past five years was reported by 78 institutions and 13 of the 78 institutions reported a corresponding decrease in the number of students specializing in school health education. Recent enrollment trends at teacher preparation institutions suggest that significant changes in professional preparation in Health Education are under way.

Health Education↗

Perceptions of quality of journals related to health education.

Faculty and chairpersons (N = 102) at 34 programs granting doctoral degrees in health education were asked to rate the quality of professional journals related to health education. The American Journal of Public Health was the highest rated journal. Health Education Quarterly was second, and Health Education Research, the only other health education journal, was rated in the top 10 (rated 7). The journals from the epidemiology area rated higher than journals from other areas. The respondents were least familiar with journals on the environment, safety, and death education.

Adult↗

Health education: perspective for PAs.

Health Education is a valid part of the PA's armamentarium which should be developed to maintain pace with the continuing role evolution of PAs. The Health Belief Model is useful as a means of understanding how patients are motivated to accept health-promoting behavioral and life-style changes. The PA, according to his or her own unique interests, experience, and ingenuity, must develop plans and methods for implementation of specific interventions, but the five priority actions delineated by the Surgeon General can serve as a basis. These include the areas of smoking cessation, alcohol and drug management, nutritional guidance, and the management of psychosocial stress. The authors provide a table of references in these areas.

Health Education↗

The evolution of health education: the Kaiser Permanente Southern California experience.

This article conveys the history of establishing the health education program, the current delivery model, and the lessons learned from the process including practical applications for the practice setting. The evolution of health education in Kaiser Permanente reflects its history and describes the continued need for and relevance of health education. The era of the patient as the passive recipient of care is being replaced by an emphasis on the patient as a partner in care. Every health education program emphasizes shared responsibility and encourages active participation by the patient, family, and other social supports. Multiple modalities of self-care and/or self-management resources and services increase member access to needed health education, health promotion, and prevention information that facilitate lifestyle behavior changes for better health and simultaneously improve organizational clinical outcome measures. Ongoing efforts align health education with regulatory requirements and the organization's commitment to culturally and linguistically appropriate patient information.

Behavior Therapy↗

Development of certified health education specialists (CHES) in the United States: focusing on the CHES responsibilities and competencies.

Health education is an important profession. The certification of health education specialists (CHES) has evolved in the United States (U.S.) over the past 50 years. This article briefly focuses on the CHES system in the U.S. and research studies related to this topic, including coverage of the CHES responsibilities and competencies by professional school programs in the U.S., as well as other CHES issues. The CHES credentialing system in the U.S. was successfully developed over a long period of time, and its history in the U.S. is unique. Japan has now started to develop a similar certification process and is concerned about academic programs for training Japanese health educators. Awareness of the CHES system and the U.S. health education certification process and framework may help Japanese health educators and academics to tailor their health education certification processes more effectively.

Certification↗

On the importance of planned health education. Prevention of ski injury as an example.

The planning of health education aimed at preventing sports injuries is often incomplete and not stated explicitly. In most instances, the evaluation is incomplete or nonexistent. We present a theoretical framework for planning and evaluating health education, illustrating the main points by using as an example the health education for downhill skiers. Systematic planning consists of analyzing the magnitude of the problem and the behavioral risk factors, studying behavior determinants, designing an optimal intervention, and implementing the intervention. The evaluation phase deals with the effects on these five levels (implementation, intervention, determinants, behavior, and incidence of injury). Some common pitfalls are mentioned and special attention is given to the study of determinants of behavior and to the design of the intervention. The importance of pretesting health education material and the community approach in educating sports participants is underlined. Health education, together with regulations and facilities, constitutes the health promotion strategy in the prevention of sports injuries. For most sports, there seems to be a strong need for further research on the etiology and determinants of behavior before effective prevention can be realized.

Athletic Injuries↗

Secondary school health education related to nutrition and physical activity--selected sites, United States, 2004.

Eating a healthful diet and engaging in physical activity have important health benefits for youths, such as reducing overweight, a condition that affected 17% of those aged 12-19 years during 2003-2004. School health education that includes information about nutrition and physical activity is an important component of a comprehensive approach to improving dietary behavior, reducing sedentary behavior, and increasing physical activity among youths. A previous study suggested that professional development for health education teachers helps ensure the quality of health education instruction. To identify which nutrition and physical activity topics are being taught in school health education courses and what percentage of lead health education teachers have received professional development on nutrition and physical activity, CDC analyzed data from the 2004 School Health Profiles for public secondary schools (i.e., middle, junior high, and senior high schools) serving students in grades 6-12 in 25 states and 10 large urban school districts. This report summarizes the results of that analysis, which indicated that in 2004, approximately one half to three fourths of schools in the participating states and school districts taught all 15 nutrition and dietary behavior topics listed in the School Health Profiles questionnaire in a required health education course, and approximately one third to two thirds taught all 12 physical activity and fitness topics. State and local education agencies should continue to encourage schools to provide education on nutrition and physical activity as part of a coordinated school health program and promote staff development for health education teachers.

Adolescent↗

An assessment of the value of health education in the prevention of childhood asthma.

A research project, which looks at the value of health education in the prevention of childhood asthma, is described. The project was a controlled trial by a health visitor focused within the community. This exploratory research looked at three groups of children over a 2-year period, and compared the effect of: (a) individual health education, and (b) group health education. During the first year, two groups were active, one receiving individual health education, the other collecting data of the same type. During the second year, a third group was involved in health education sessions. The findings have been similar in both cases, in that both groups have demonstrated a good improvement in knowledge of asthma and its treatment. Through the active involvement of using a peakflow meter and diary records in the health education programme, both groups receiving health education have shown a significant improvement in the morbidity indicators related to night symptoms and restricted activities. The qualitative analysis of the research also highlighted the value parents of asthmatic children place on counselling.

Absenteeism↗

The development of culturally appropriate health education materials.

Addressing the extensive health needs of linguistic minority populations often requires the development of culturally appropriate health education materials. This article describes the preparation and evaluation of health education materials on medication that were tailored for the Latino and Southeast Asian clients. The culturally sensitive adaptation of materials and the involvement of community representatives are critical steps in this process. The number of requests for these materials illustrated the widespread need for this type of media.

Asian↗