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PubMed1980

Health education evaluation: an alternate research paradigm.

A major disappointment with educational evaluative research in general, and health education evaluation in particular, is all too often outcome of "no significant difference" or "no effect." Reviewing the evaluation literature one finds experienced investigators such as Donald Campbell, Marcia Guttentag, and Carol Weiss lamenting the fact that educational programs persistently fail to uncover statistical differences. This problem continues to plague evaluators whose experiential evidence indicates that the program may have produced some very desirable results. Thus, the traditional methods of evaluation are increasingly being called into question. Evaluators are presenting theories to explain the "no effects" phenomenon and alternate methodologies are being proposed in the literature. This article suggests that health educators not only acknowledge the existence of this dilemma, but develop a working knowledge of alternate or qualitative data methodologies, their possibilities, and their limitations, thus encouraging the evaluation of those health programs which have traditionally been classified as undoable.

Evaluation Studies as Topic↗

PubMed1997

Increasing compliance with colorectal cancer screening: the development of effective health education.

The ability of a health education leaflet to raise awareness of the frequency of colorectal cancer and its asymptomatic nature and to increase intention to participate in screening with faecal occult blood testing (FOBT) was investigated. One hundred subjects were interviewed before and after reading the leaflet. The number of men stating bowel cancer was 'very common' increased significantly from 20 to 60% (chi 2 = 16.7, P < 0.0001) and those understanding its asymptomatic nature form 64 to 92% (chi 2 = 11.4, P < 0.001). The leaflet significantly increased the percentage of women reporting bowel cancer as 'very common' from 30 to 70% (chi 2 = 16.0, P < 0.0001) and as being asymptomatic from 58 to 94% (chi 2 = 17.8, P < 0.0001). After reading the leaflet, 55% of men who initially declined screening reversed their decision (chi 2 16.5, P < 0.0001) and 50% of female non-adherers reversed their decision (chi 2 = 17.3, P < 0.0001). Reasons most frequently given for declining colorectal cancer screening were feeling well (77% of subjects declining), concern about further tests (38%), unpleasantness of FOBT (13%) and illness (6%). This leaflet successfully educates people about colorectal cancer and increased intention to participate in screening programmes.

Aged↗

PubMedDate not supplied

[Health education: a transforming experience].

This article describes the positive and transforming experience of the 'health education' practice, highlighting the results produced on both educators and the people who participated in the education process. The work took place in 2003 in the city of Manacapuru-Amazonas, and it consisted of educational activities designed for teenagers from a public school of the city The educative activities were based on a methodology for nursing assistance to collective health, using its phases. The results showed, in fact, that health education is essential to the reflection and change of behavior in people's lives. Therefore, health education must be systematically planned and adopted as an important role of the nursing professional.

Adolescent↗

PubMed2006

Teachers' perceptions of health education practice in Northern Ireland: reported differences between policy and non-policy holding schools.

It is generally accepted that schools should devote resources to developing and disseminating a health education policy, yet there is little empirical evidence to establish the value of policy in this context. This study examined teachers' perceptions of health education practice in policy and non-policy holding schools. A questionnaire measuring aspects of health education practice was issued to a random sample of schools. This consisted of 276 primary and 119 post-primary schools. In this cross-sectional study, significant differences in teachers' evaluations were found between policy and non-policy holding schools. It was evident that the presence of a health education policy was associated with higher ratings of health education practice. This evidence suggests that policy has intrinsic value in terms of health education practice. The development and dissemination of policy documents were also examined to assess the workload involved.

Adult↗

PubMedDate not supplied

[Comparative study of the level of health education of primary and secondary teachers].

A study was carried out on the health education level among primary and secondary school teachers in the municipality of Artemisa, in relation with the prevention of the most frequent oral diseases. So, a sample representing 60% of the universe under study was surveyed. An assessing method was established rating sanitary education levels as good, deficient and poor. Comparisons were made among the different groups--by age, sex, educational level, and negative points which influenced most on the rating in connection with the health education levels. Finally, it is concluded that the health education level is deficient for the largest percent of the group under study.

Adult↗

PubMed1988

The State Planning Committee for Health Education in Ohio.

The State Planning Committee for Health Education in Ohio (SPCHEO) developed and applied a model for improving comprehensive school health programs that can be adapted and facilitated by health education coalitions or professional associations in any state. The model is based on development of a well-rounded school-community health team. SPCHEO members who assume the role of team organizers facilitate a planning process that includes building a school-community health team, assessing and analyzing school health instruction, services, environment, and administration, establishing priorities, goals, and objectives, identifying resources, implementing strategies, and evaluation. The model stimulates action toward improved comprehensive school health programs. A new adaptation of the model is being explored to expand its impact.

Child↗

PubMed1988

Multicultural health education: an emerging reality in Canada.

This article attempts to melt the two concepts of multiculturalism and health education. It defines multicultural health education and provides a rationale, presents a series of examples of what is presently being done in Canada, identifies needs and gaps, and proposes a number of potential strategies for furthering the development of the field of multicultural health education.

Canada↗

PubMed1998

The effects of postnatal health education for mothers on infant care and family planning practices in Nepal: a randomised controlled trial.

OBJECTIVES: To evaluate impact of postnatal health education for mothers on infant care and postnatal family planning practices in Nepal. DESIGN: Randomised controlled trial with community follow up at 3 and 6 months post partum by interview. Initial household survey of study areas to identify all pregnant women to facilitate follow up. SETTING: Main maternity hospital in Kathmandu, Nepal. Follow up in urban Kathmandu and a periurban area southwest of the city. SUBJECTS: 540 mothers randomly allocated to one of four groups: health education immediately after birth and three months later (group A), at birth only (group B), at three months only (group C), or none (group D). INTERVENTIONS: Structured baseline household questionnaire; 20 minute, one to one health education at birth and three months later. MAIN OUTCOME MEASURES: Duration of exclusive breast feeding, appropriate immunisation of infant, knowledge of oral rehydration solution and need to continue breast feeding in diarrhoea, knowledge of infant signs suggesting pneumonia, uptake of postnatal family planning. RESULTS: Mothers in groups A and B (received health education at birth) were slightly more likely to use contraception at six months after birth compared with mothers in groups C and D (no health education at birth) (odds ratio 1.62, 95% confidence interval 1.06 to 2.5). There were no other significant differences between groups with regards to infant feeding, infant care, or immunisation. CONCLUSIONS: Our findings suggest that the recommended practice of individual health education for postnatal mothers in poor communities has no impact on infant feeding, care, or immunisation, although uptake of family planning may be slightly enhanced.

Breast Feeding↗

PubMed1993

Crutches, confetti or useful tools? Professionals' views on and use of health education leaflets.

This paper examines the views on and use of health education leaflets by a number of professional groups: health visitors, midwives, occupational health workers, pharmacists and school health education co-ordinators. Eighty nine percent currently obtain leaflets from health promotion units, with the exception of health visitors, professionals are largely satisfied with the units' service. Seventy six percent use commercial or sponsored leaflets primarily because of the large numbers and topics that are available. The numbers and type of leaflets used were found to vary across the professions. All professionals see an increasingly important role for leaflets in their work. A number of them, pharmacists and occupational health workers in particular, saw the numbers they use rising. These views were accompanied by lower levels of belief in a leaflets ability to increase knowledge and behaviour as well as lower levels of satisfaction with current leaflet use and a concern over the public's reception of leaflets. Methods of leaflet distribution to the public largely reflect the professionals' work contexts. Most popular were handing out leaflets with advice, leaving them in a public place and using them as a back-up to a meeting. A number of contradictions emerge between distribution practices and perceived effectiveness. Few professionals thought leaving leaflets in a public place was effective, and few health visitors and midwives believed giving leaflets to the family of a client was effective despite large numbers doing so. The implications of these findings for health promotion policy and practice are discussed.

Attitude of Health Personnel↗

PubMed2005

Reproductive health education and sexual risk among high-risk female adolescents and young adults.

STUDY OBJECTIVE: The objective of this study was to explore the associations of sources, content, and timing of reproductive health education with cognitive and behavioral sexual risk in a sample of high-risk female adolescents and young adults. DESIGN: Female adolescents and young adults (n=113, median age 17 years) receiving treatment for a sexually transmitted disease (STD) reported sources of reproductive health education, topics covered, and when first formal education occurred. Dependent variables included sexual risk knowledge; condom attitudes, negotiation skills, and use (consistent and at last sex); and number of sexual partners. RESULTS: Most participants reported receiving reproductive health education from both parental (80%) and formal sources (92%). Parents discussed the menstrual cycle (94%) more frequently than other sex education topics, while formal sources focused most on teaching about STDs (91%). Although median age of first formal instruction was 12 years, 26% of girls received their first formal education during or after the year they initiated coitus. Girls with a parental source of education and those receiving formal instruction on pregnancy reported greater ability to negotiate condom use. Girls who received education later in relation to the onset of sexual activity and those with a parental source of education reported more sexual partners. CONCLUSIONS: Early reproductive health education and education from both parental and formal sources is associated with reduced sexual risk among high-risk adolescent girls. Interestingly, receiving parental education is also associated with more sexual partners, suggesting that parental educational efforts may be reactive to their daughters' increasing sexual risk behavior. Future research should examine multiple sources of reproductive health education and the timing of education from these sources to enhance understanding the dynamic interactions between reproductive health education and adolescent sexual risk.

Adolescent↗

PubMed1993

Bringing comprehensive health education to the New York City Public Schools: a private-public success story.

The New York Academy of Medicine has pioneered a far-sighted effort which successfully introduced two model health education curricula into the New York City Public Schools at both the elementary and middle school levels. The curriculums for kindergarten through sixth grades, Growing Healthy, are currently being used in 525 of New York's 625 elementary schools, and the curriculum for seventh and eighth grades, Being Healthy, is in place in 60 of 200 junior high schools. These curricula offer a comprehensive approach to health education that promotes emotional well-being as well as physical health by improving health behaviors, attitudes, and academic performance of students through hands-on and interactive activities which develop decision-making skills and the ability to make healthful choices. The program has met with ongoing success and expanding influence, as the result of several important factors. First, the New York Academy of Medicine took a leadership role in supporting a venture outside its own walls and became an active advocate for comprehensive health education in the public schools. The Academy's standing as a prestigious yet independent medical association brought influence to the organizing efforts and contributed the credibility needed to get the program off the ground. Second, the Division of Student Support Services of the New York City Public Schools gave strong acceptance and cooperation leading to ongoing financial support and institutionalization of the program. Added to that is the enthusiasm of teachers, administrators, and other in-school personnel who have made the lessons of Growing Healthy and Being Healthy meaningful by reaching hundreds of thousands of students across New York City. Another important factor is the oversight and longevity which has been provided by the unusual gathering of doctors, educators, public health specialists, funders, and city administrators who created an effective private-public coalition 15 years ago and have remained committed to working together. Last through its ongoing efforts, the Academy's Office of School Health Programs has stayed at the forefront of developments in health education. By continuing to evaluate their activities and by constantly integrating new materials into the existing curricular framework, they have demonstrated that a comprehensive health education program can be both meaningful to children and responsive to community needs by reflecting current public health issues and concerns.

Child↗

PubMed1989

Health education using video recordings in a general practice waiting area: an evaluation.

With the help of a patient participation group video recordings of health education programmes were shown in the waiting area of a health centre. Patients could choose whether or not to watch the programmes. When asked their views on the project 87% of patients responded positively, and 50% of those who watched could recall specific facts presented. There were no significant differences in age or sex between those who chose and chose not to watch the video recordings. However, unemployed patients and those in social classes 4 and 5 were significantly less likely to watch the programmes than those in social classes 1-3. The use of video recordings in both primary care and hospital waiting areas and the possible role of the health education authority as a central resource is discussed. This system could provide a useful means of extending health education, although further research is needed on the response of different social classes to different forms of health education.

Attitude to Health↗

PubMed2005

Reproductive health education intervention trial.

OBJECTIVE: To measure the effectiveness of a reproductive health education package in improving the knowledge of adolescent girls aged 15-19 years in Chandigarh (India). METHODS: A reproductive health education package, developed in consultation with parents, teachers and adolescents, was delivered to randomly sampled classes of two senior secondary schools and one school was selected as control. In one school, a nurse conducted 15 sessions for 94 students in three batches using conventional education approach. In another school she conducted sessions for a selected group of 20 adolescents who later disseminated the messages informally to their 84 classmates (peer education). Using a 70-item structured questionnaire the knowledge of 95 adolescents from conventional, 84 from peer, and 94 from control school were assessed before and one month after the last session. Change in the score in intervention and control groups was tested by ANOVA taking age and socio-economic status as covariates. RESULTS: Teachers, parents and students overwhelmingly (88%, 95.5% and 93% respectively) favoured reproductive health education program. Five percent of the respondents reported that someone in their class is having sexual relations, and 13% of the girls approved of pre-marital sexual relations. Reproductive health knowledge scores improved significantly after intervention in conventional education (27.28) and peer education group (20.77) in comparison to the controls (3.64). Post-test scores were not significantly different between peer education group and conventional education group (43.65 and 40.52 respectively) though the time consumed in delivering the peer education intervention was almost one third of the time taken to implement conventional education. CONCLUSION: Peer education and conventional education strategies were effective in improving the reproductive health knowledge of adolescent girls but peer strategy was less time consuming.

Adolescent↗

PubMed2001

Wrestling with ethnic diversity: toward empowering health educators.

UNLABELLED: The importance of training health professionals for work in an ethnically diverse society is increasingly recognized. However, health educators may lack confidence or experience in delivering such teaching, contributing to a self-perpetuating inertia. OBJECTIVES: To identify current experience and challenges perceived by educators of different health professionals, and to facilitate and debate the development of teaching in this field. METHODS: Educators (n=61) from 42 different organizations, participated in facilitated workshops in three different UK settings. They included clinician teachers of medical undergraduates and postgraduates, and educators of nurses, primary care and hospital physicians, physiotherapists, occupational therapists and paramedical staff. Opportunities were provided for educators to discuss experiences; to participate as "learners" in examples of interactive training exercises; to anticipate challenges they might encounter in developing and providing training themselves; and to discuss ways of negotiating them. Qualitative data generated from the workshops were analysed for common themes. RESULTS: Participants had received little relevant training themselves. For many, the workshops provided a first formal opportunity to consider their own responses to ethnic diversity in health care. Current provision of such training in their institutions was limited. Educators lacked specific training to facilitate the learning of others in this field. They wrestled with a wide range of issues: from critical dilemmas about the philosophy of teaching, through to the practicalities and personal challenges of face to face teaching. Strategies to address these were generated that may merit consideration. CONCLUSION: Educators will need help to overcome their uncertainty in approaching this topic and be empowered to develop training. Developing teachers' own awareness and skills, followed by appropriate support, are likely to be prerequisites for successful training.

Cultural Diversity↗

PubMed1991

[Physician-patient communication and health education].

The aim of the present study was to analyze the content in health education of the patient-physician interview. The study was observational and descriptive. The target population were the patients attending the general practices of the Social Security clinics. With permission of patients and physicians, 53 visits of two general practitioners were recorded on tape. 48 interviews were analyzed with definition of activities (asking, answering, discussing, etc.) and contents (health problems, treatment, health education, etc.). Health education was 10% of the contents, and it was associated with the physician's activity of commenting/instructing and with the patient's activity of commenting/asking.

Interviews as Topic↗

PubMed1995

Health education and antibiotic therapy in trachoma control.

The objective of this study was to confirm whether the combination of a health education programme with a mass treatment campaign was able to improve the effectiveness of trachoma control. An open controlled clinical trial with a 2 x 2 factorial design was carried out. Four villages, matched for size and epidemiological, economic and social conditions, were included in the study. The first village received mass treatment with 1% oxytetracycline eye drops combined with a specific health education programme. The second village received only a health education programme. The third village received only mass treatment and the fourth village did not receive any intervention during the study (control village). 1810 subjects were enrolled of whom 76% were successfully followed for 6 months. The incidence of new cases ranged between 1.6% and 14.2%. In this study the combination of a health education programme with mass treatment failed to increase the cure rate. There was even a negative interaction (P = 0.03). The best results were obtained in the village where antibiotic treatment was used alone, both in terms of cure rate (82%) and reduction of C trachomatis transmission. These results suggest that the addition of a health education programme does not systematically improve the performances of a mass treatment campaign. The efficacy of this combination depends essentially on the capacity of the community to modify its hygiene behaviour.

Anti-Bacterial Agents↗

PubMed1981

Reintegration: the slow march of progress--towards a reality-oriented concept of health education.

The essay sets out to plead for a basic reassessment of many of the implicit or explicit "conceptual props and crutches" upholding traditional health education. Its main thrust is to reconstruct the many disparate bits and pieces of theoretical assumption which have come into being through the various historical phases of health education and, in doing so, to rebuild an image of social reality in which health educators can hope to operate more meaningfully and, possibly, more effectively. The general theory behind the call for an integrated approach to health education is that this art can only thrive when openly confronted with its traditional limitations determined both by limits of social awareness and social structure. These have to be made the subject of discussion on health education "theory" in order to affect change. Examples of an alternate approach applied in the Federal Republic of Germany are quoted to stimulate discussion.

Goals↗

PubMed1995

Tuberculosis health education. Needs in homeless shelters.

Tuberculosis has reemerged as an important public health concern, particularly with the rise in multi-drug-resistant strains. The homeless are at increased risk for infection, for active disease, and for incomplete treatment. Public health authorities have recommended that tuberculosis health education materials be developed specifically for residents and staff of homeless shelters. In this study, a diverse sample of 20 adult homeless-shelter residents responded to open-ended questions regarding 1) their knowledge of tuberculosis and tuberculosis screening and treatment, 2) their perceptions of access to health care services related to tuberculosis, and 3) their views of health education regarding tuberculosis. The majority of the subjects had limited knowledge of tuberculosis and of screening and treatment for the disease. Many had misconceptions about the disease, particularly regarding its transmission. An analysis of the subjects' responses within the framework of the Health Belief Model indicated that basic tuberculosis health education programs for residents of homeless shelters are needed. The study findings indicated that a small-group educational format utilizing written materials and video aids might be most effective.

Adolescent↗