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Four experiences in health education in communities located in the state of Lara in Venezuela were analyzed from a sociopsychological perspective. Under a qualitative approach, the information was obtained from three sources: documentary analysis of didactic material; participant observation in workshops, and interviews to leaders and participants.
The author argues that health education, which he defines as dealing responsibly with information about health, cannot effectively cover large groups of population without government support. Community action, both through individuals and groups, and social action of a more organized nature are among the key forces that have an impact on improving health: it is the government's responsibility to provide an administrative and legislative framework that is supportive of such action. Other government responsibilities include: (a) recognition of the role of voluntary agencies and facilitating their participation; (b) sharing information about health and the health consequences of certain practices and behaviours with the entire population, and (c) financial responsibility in developing a policy for health promotion. For the author, the most important form of government is local government which calls for effective participation from within through political elections and administrative processes. Current trends indicate that decentralization, in many countries, is more than lip-service. Such a process has important health implications and is also a major aspect of government support of health education and health promotion. Non-involvement of government in health education is impossible today and a health oriented policy can provide an essential and even crucial framework for community and social action for health.
The inclusion of health education in high quality primary care has been suggested on the basis of 1) definitions and descriptions and descriptions of the content of primary care practice; 2) observational studies which have found that about 25 per cent of the direct patient-care time of the primary care physician is devoted to health education and counseling; and 3) surveys of physicians, who identified the most important "critical incidents" contributing to desired medical outcomes. This article reviews empirical studies of the role of health education in improving behavioral and medical outcomes for such conditions as hypertension, diabetes, congestive heart disease, streptococcal infections and others. Other contributions of health education in primary care in schools and other community settings are cited. Finally, the possible role of health education in medical education programs is described.
Health education is of great importance in therapy and rehabilitation of patients with chronic obstructive lung diseases. A healthy manner of living has great influence on the success and effectivity of therapy and rehabilitation. In this paper a report is given on the systematic integration of health education in the daily work of a great chest hospital, especially regarding the main topics of health education in lung diseases and the specific methodic possibilities in a hospital as well as the systematic integration in the management and the self-improvement of the medical staff.
The problem health education faces in Spanish schools is the inconsistency between objectives and means. Therefore, it is common to find health education initiatives limited by not only lack of institutional support and training of professionals, but also by its adherence to a theory-based learning. This article analyses the need for a practical alternative, which would involve researchers/teachers and students in thinking and building the best health practices for them and their community. Parent-like behaviour, based on information and/or persuasion, looks to protect adolescent health and well-being until they are able to take on responsibility of their own, despite the fact that adolescents' search for knowledge influences their own perceptions of what is best for individual and community health. In order to tackle this challenge faced by health educators, in contrast to the theory-based teaching model, it is necessary to implicate the people into the learning process. An in depth study on the definition of health education paradigms (informative, persuasive and political-ecological) (García et al., 2001) has been developed, and which Jensen (1997) divides into two types: moral (informative) and democratic (ecological). As part of this process to transform health education into a participatory practice, and given its social impact, there is also a need to implement health education at higher educational levels and not only in primary and secondary school as occurs in Spain. Turning universities into 'health promoting agencies' (Dooris, 2001) would imply coordinating education with personal, professional and community action, and would be supported and driven by organisational change at university level and would require the participation of all involved when defining the course of action. As a consequence, the people involved in health education learning processes at university level would improve not only their quality of life, but they would also build capacity to influence the different sectors of society they are in contact with (Toyne and Ali-Khan, 1998.).
There is no doubt that gender bias has been inherent in medical and public health education, research, and clinical practice. This paper discusses the central question for medical and public health educators viz. whether women's health concerns and needs could be best addressed by the conventional biomedical approach to medical and public health education, research, and practice. Gender inequalities in health and gender bias in medical and public health education are revealed. It is found that in most public health and prevention issues related to women's health, the core issue is male-female power relations, and not merely the lack of public health services, medical technology, or information. There is, thus, an urgent need to gender-sensitize public health and medical education. The paper proposes a gender analysis of health to distinguish between biological causes and social explanations for the health differentials between men and women. It also assessed some of the gender approaches to public health and medical education currently adopted in the Asia-Pacific region. It poses the pressing question of how medical and public health educators integrate the gender perspective into medical and public health education. The paper exhorts all medical and public health practitioners to explore new directions and identify innovative strategies to formulate a gender-sensitive curriculum towards the best practices in medicine and public health that will meet the health needs of women and men in the 21st century.
How can health educators influence public policy so as to increase the resources for disease prevention? The following case history of the New York City Coalition to End Lead Poisoning (NYCCELP) describes how an advocacy group sought to educate parents, health workers and policy makers about a major urban health problem. Using health education techniques such as small group meetings, mass media coverage and community organizing, NYCCELP hoped to persuade city agencies to enforce more systematically existing laws for the prevention of lead poisoning and to allocate more resources for screening and education. By defining the problem of lead poisoning broadly, the Coalition was able to attract diverse constituencies including housing organizations, public health advocacy groups, public interest lawyers, elected officials and children's rights groups. In part as a result of NYCCELP's efforts, the city government has screened more children for lead poisoning, hired additional health educators, enforced relevant sections of the housing code more often, and allocated new resources for lead poisoning control.
To assess the effectiveness of health education in relation to the changes it produces in both information and the general population's outlook on food consumption. DESIGN. A controlled intervention study, with a randomized double-blind sample. PLACE. Village covered by the Fuenlabrada Health Centre. PARTICIPANTS. 88 families agreed to take part, out of the 408 that made up the total sample for the field study on food consumption previously undertaken. 24 families in the intervention group (46% loss) and 35 in the control group (20% loss) completed the study. ACTIVITY. A group of nurses with diplomas in Health Education delivered advice and instruction on diet and health to the families in the study group, during April, May and June, 1990. MEASUREMENTS AND MAIN RESULTS. Two kinds of questionnaires, both previously validated, were used to measure the varying levels of food consumption and of information. These questionnaires were filled by both sample groups (intervention and control), before and after the health education. The level of knowledge, taking into account the number of positive answers in the information questionnaire, was significantly higher in the intervention group than in the control one (p less than 0.005). The level of food consumption was significantly higher in the meat intervention group, attaining an average of 3.08 (2.46-3.67); whereas in the control group an average of 4.39 was obtained. (3.72-5.06) (p less than 0.005). CONCLUSIONS. There was scant participation among the healthy population.(ABSTRACT TRUNCATED AT 250 WORDS)
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Theoretical models and paradigms from the behavioral sciences which appear most frequently in the explanation and design of health education are reviewed and consolidated around a single classification of change processes. Kelman's definitions of internalization, identification, and compliance are used to subsume parallel classifications of motivational, sociological, cultural, organizational, and communication variables. The theorematic integration of these numerous variables presents a variety of new hypotheses and suggestions for educational diagnosis, health education planning and evaluation, and potential logistics for computer programming of decision models in health education.
BACKGROUND: Since health promotion and health education are developing concepts around the world, the purpose of this paper was to compare theory and practice, at certain point in time in various countries. METHODS: Data were collected using the structured direct interview. We approached 16 participants at the XVI World Conference on Health Promotion and Education. The responses of 11 participants were analyzed. RESULTS: Health promotion is a separate profession in 4 out of 11 countries. Physicians are responsible for health promotion and education in all 11 countries. School was identified as a health promotion setting in all 11 countries, while community and hospital in 10. The Ottawa Charter (1986) guided the definition of health promotion for all participants, while 7 participants defined health promotion and health education differently. CONCLUSION: Unified definition of terms may allow similar practice at the international level; comprehensive approach to health includes all aspects of health, determinants, settings and practitioners; there occurs the need for health education as a separate profession globally.
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To accurately assess the health knowledge, attitudes, and practices of students in grades four-seven, the staff of the School Health Education Evaluation (SHEE) project devoted extensive effort to identify a test appropriate for such assessment. An extensive literature review failed to produce an instrument sufficiently comprehensive or psychometrically sound that could be employed. In this paper, the philosophic orientation and the detailed processes followed in developing a noncurriculum specific, psychometrically sound evaluation instrument for use in the study is described. Included are the bases for the test framework, test objective development, test item review, the various measures constructed using the test blueprint, student performance on the test battery, the psychometric qualities of the test, and suggestions for appropriate use of the final test in other school health education settings.
Considering the attention given to health education and promotion, it is surprising that little research assesses the opinions and behavioral inclinations of physicians. Survey data collected in Florida address this issue. Responses of primary care private practitioners reveal that whereas MDs endorse health promotion and acknowledge a link between positive lifestyle and health, their outlook regarding the potential of community-based health education remains skeptical. A majority blame ineffective health education on public apathy. Nonetheless, a sizeable minority are willing to either begin or increase their involvement in health education programs. Multivariate analyses suggest that active or receptive MDs view the public's lifestyle knowledge as inadequate and select the MD as the health professional most suited to assume primary responsibility for health education. Clues for identifying practitioners who might engage in further health education are provided by examining age, specialty, patient load and community size. For example, GPs/FPs might more readily endorse an educational program if it allows for one-to-one physician-patient interaction; emphasizing this instructional mode appears less important in securing the cooperation of their more specialized primary care counterparts. Further, MDs with the larger caseloads are more likely to view health education as the physician's responsibility.
Many forms of media used in health education today have only a limited effect in promoting a healthy lifestyle. One of the reasons for this is the lack of formative assessment instruments to identify weak points in the media that are used. Another problem is the insufficient attention paid to different socio-cultural variables in choosing suitable media for particular audiences in a culturally diverse society. This article presents a model for grading media appropriateness and cultural sensitivity in health education. The model is based on the interaction between three cornerstones, namely the principles of health education, appropriate media and technology, and socio-cultural sensitivity. A strong point of this model is its flexibility, because it can be combined with other instruments for formative assessment of different health learning materials.
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Inservice training to promote health education is important and, for it to be truly effective, teachers must be intimately involved from the beginning. This article describes the operation of the Portal School Program at Arizona State University which is one method for promoting health education in elementary schools. The program is easy to implement and has been shown to be effective. The program uses a three-phase approach of development, dissemination, and review. It provides for the development of teacher designed health education materials, promotes the use of these materials in the classroom, and provides a mechanism for their review and refinement.