Health Education and Promotion Concepts

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HEALTH EDUCATION
&
Promotion Concepts
Prof. AWATIF ALAM & Prof. ASHRY GAD
Department of Family & Community
Medicine
KSU
Definition:
  
Health education is the process by which
individuals and group of people learn to 
:
Promote, Maintain, Restore health
Address risks, prevent disease/injury
 
Education for health begins with people as
they are, with whatever interests they
may have in improving their living
conditions
.
 
 
A planned combination of educational,
political, regulatory, and organizational
supports for actions and conditions of living
conducive to the health of individuals,
groups, or communities.
DEFINITIONS OF HEALTH PROMOTION
Green & Kreuter, 1999
Green & Kreuter, 1999
 
 
The process of enabling people to increase control
over and improve their health…
A commitment to dealing with challenges of
reducing inequities, extending the scope of
prevention, and helping people to cope with their
circumstances…
Creating environments conducive to health, in
which people are better able to take care of
themselves
DEFINITIONS OF HEALTH PROMOTION
BASIC CHARACTERISTICS
OF HEALTH PROMOTION
1.
E
nabling people to take control over, and
responsibility for, their health as an important
component of everyday life.
2.
Requiring the close cooperation of sectors
beyond the health services.
3.
Combining diverse, but complimentary,
methods or approaches.
4.
Encouraging effective and concrete public
participation.
Health Promotion Action Means:
Build Public Health Policy
Create Supportive Environments
Strengthen Community Actions
Develop Personal Skills
Re-orient Health Services
Moving into the future
            THE TRIAD OF HEALTH PROMOTION
 
 
HEALTH
HEALTH
EDUCATION
EDUCATION
 
 
HEALTH
HEALTH
PROTECTION
PROTECTION
 
 
DISEASE
DISEASE
PREVENTION
PREVENTION
The Health Promotion Triad
The Health Promotion Triad
DISEASE PREVENTION
TH
REE LEVELS
 
 
P
rimary
 
Secon
dary
 
Tertiary
Primary 
Prevention
Secondary
Prevention
Healthy
individual
Biological
onset of
disease
Risk 
Factors
Immunization
Health
Education
Prophylaxis
Screening
Surveillance
Rehabilitation
Support
Asymptomatic
signs
Functional
Status
Symptoms and
signs
Diagnosis
Treatment
Compliance
Adherence
The Phases of Prevention in relation to
natural history of disease
Clinical
Course of
disease
Chronic
disease
Cure
Disability
Death
Tertiary 
Prevention
undefined
Health Promotion Context: Place of
Health Education in Public Health
THREE SPHERES
Health Education
Prevention
Health Protection
SEVEN DOMAINS
1.
Prevention
2.
Lifestyle
3.
Preventive Policies
4.
Policy Maker
  
Education
5. 
  
Health Education
6.  
 
Health Protection
7.  
 
Policy Support
HEALTH PROMOTION MODELS
13
Health Promotion
(Ottawa Charter)
 
Process of enabling people to increase control over, and to improve, their
health…
 
…. health promotion is not just the responsibility of health sector, but
goes beyond healthy life styles to well being
 
Health Promotion concept recognizes the role of socio-political environment,
public policies, health system and access to care, physical environment, culture,
and health related attitudes and behaviors towards health and diseases
. Health
Education targets health related beliefs, attitudes and behaviors of individuals
and populations
. Therefore, while Health Education plays an important role  there
is a need to understand that a larger role is played by national policies, social
context, cultural values, health system access
14
Health Promotion – Framework
 
Advocacy
 to make political, economic, social, environmental, cultural,
behavioral & biological factors favorable to health.
 
 
Enable
 people by ensuring equal opportunities
associated text refers to 
opportunities for access to information, life skills,
and making health choices (HEALTH EDUCATION contributes to achieving this
goal)
 -- [and this enables person to take action]
 
 
Mediate
 a coordinated action by government, health, social and economic
sectors, NGOs, Industry, professional & social groups
15
Health Promotion Actions
 
Healthy Public
 
Policies
 -- for healthier goods & services,
healthier environment, equal opportunities
 
Creation of Supportive
 
Environment
Environment  - Social, Physical
Work, Community, Society levels
 
Strengthening Community Actions
Community participation, empowerment, action. 
Health Education
also helps in empowering people for effective participation and
taking part in actions which make positive changes to environment,
health care services, policies
16
Health Promotion Actions (contd.)
 
Develop Personal Skills
 
By education, information, training
 
 
Reorient Health Services
 
Health sector must move in a HP direction beyond clinical
 
Respect cultural needs
17
Targets of health education: definitions
Health Behaviour
: Activity undertaken for the purpose of
prevention of diseases, or detecting these at an early stage, or
managing them effectively
Belief
: A statement or body of statements held to be true by an
individual or group. 
Attitude
: Position, disposition, or manner with regard to a
person or thing
AIMS OF HEALTH EDUCATION:
1. 
To develop a sense of responsibility for health conditions, as
individuals,  as members of families & communities.
       (Promotion ,prevention of disease & early diagnosis and
management ). While, as mentioned previously, environment,
policy, social context plays a major role towards shaping the
health attitudes and behaviors, information, knowledge and
skills at personal level are also important to adopt healthy
behaviors
2.   To promote and wisely use the available health services.
3.   To be part of all education, and to continue throughout whole
span of life.
Process of health education:
Dissemination of scientific knowledge
 
about how to promote and maintain health),
   
lead to changes in the Knowledge, Attitudes, and
Practices (behavior) related to such changes.
Steps for adopting new ideas & practices :
AWARENESS 
(Know about new ideas)
INTEREST     
(Seeks more details
 )
EVALUATION
 
(Advantages versus disadvant.+ testing usefulness )
 TRIAL
       
(Decision put into practice)
 
ADOPTION 
(person feels new
 
idea is good and adopts it)
Contents of Health Education
RISK FACTORS: e.g. smoking, drugs, road traffic accident risks
HEALTH ENHACING PRACTICES: e.g. exercise, nutrition
OCCUPATIONAL FACTORS: Safety, Hygiene
INFECTION CONTROL: e.g. hand washing
CHRONIC ILLNESS, MENTAL HELATH: Knowledge about risks,
improvement actions such as promoting togetherness
SEXUAL HEALTH i.e. information about STI
HEALTH SERVICES: Information about access, Awareness
about the need to use the health services
SPECIAL GROUPS (food handlers, occupations, mothers, school
health)
Principles of
Health Education
Interest
Participation
Motivation
Comprehension
Proceeding from the known to the unknown
Reinforcement through repetition
Good human relations
People
, 
facts
 and 
media
:
 
knowledgeable
, 
attractive
 , 
palatable & acceptable
 
.
Principles of
Health Education
Learning by doing:
   
 If I hear, I forget
      If I see, I remember
      If I do, I know
.
Motivation 
i.e. awakening the desire to know and learn:
    
- Primary motives,
 e.g. inborn desires, hunger
    
- Secondary motives,
 i.e. desires created by incentives
such as praise, love, recognition, competition.
24
Health Education: Individuals
About
For example, for Healthy behaviors (e.g. breast feeding),
secondary prevention
Settings where education is imparted
Health care settings, Home, Video/Internet
Approaches to health education for individuals
Risk assessments in various settings
Information, contract, evaluation for behavior change
Methods for health education for individuals
Information provision in-person, print/electronic media
Issues
High Cost, Focus on Disease rather than on health
25
Health Education: Groups
About
Behavior change, supportive environment,
community action, access to care
Settings
Health care settings, community, workplace
Approaches
Knowledge & skill development
Peer learning
Training for behavior change
Methods
Didactic & experiential methods
Issues
Difficult to comprehend and manage group dynamics,
difficult to achieve skills to facilitate groups
Communication in health education:
Education is primarily a matter of communication, the components of
which are:
 
CHANNELS 
           
AUDIENCE  
         
MESSAGE 
         
COMMUNICATOR
                               - Individual       - 
Conform with
       - Educator
- Media                  - Group                   
objectives.
-----------------------------------------------------------------------------------------
- 
2 way
                      
- Public
               - understandable     - needs+ interest
                                                                                                       of audience
-----------------------------------------------------------------------------------------
- 1 way
                      
- Public
                  
- Acceptable
           - ? Content of
                                                                                                           message
-----------------------------------------------------------------------------------------
Evaluation of health education programs:
There should be continuous
evaluation.
Evaluation should 
not
 be
left to the end but should
be done from time to time
for purpose of making
modifications to achieve
better results.
EVALUATION CYCLE:
Describe problem
    
Describe program
     
State goals
          
Determine needed
                                                                                              
information
  
Modify program
                                                                
Establish basis for
                                                                                        
proof of effectiveness
                                                                                        
 
Analyze &compare
     
Organize data
       
Develop& test
       
Determine  data        
      results                       base
                    
instruments 
 
          
collecting 
method
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Health education is the process through which individuals and groups learn to promote, maintain, and restore health while addressing risks and preventing diseases and injuries. Health promotion involves planned actions to improve living conditions conducive to health, empower individuals, and create supportive environments. Basic characteristics include promoting public health policy, community actions, personal skills development, and re-orienting health services. The triad of health promotion encompasses health education, health protection, and disease prevention.

  • Health Education
  • Health Promotion
  • Public Health
  • Prevention
  • Community Medicine

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  1. HEALTH EDUCATION & Promotion Concepts Prof. AWATIF ALAM & Prof. ASHRY GAD Department of Family & Community Medicine KSU

  2. Definition: Health education is the process by which individuals and group of people learn to : Promote, Maintain, Restore health Address risks, prevent disease/injury Education for health begins with people as they are, with whatever interests they may have in improving their living conditions .

  3. DEFINITIONS OF HEALTH PROMOTION A planned combination of educational, political, regulatory, and organizational supports for actions and conditions of living conducive to the health of individuals, groups, or communities. Green & Kreuter, 1999

  4. DEFINITIONS OF HEALTH PROMOTION The process of enabling people to increase control over and improve their health A commitment to dealing with challenges of reducing inequities, extending the scope of prevention, and helping people to cope with their circumstances Creating environments conducive to health, in which people are better able to take care of themselves

  5. BASIC CHARACTERISTICS OF HEALTH PROMOTION 1. Enabling people to take control over, and responsibility for, their health as an important component of everyday life. 2. Requiring the close cooperation of sectors beyond the health services. 3. Combining diverse, but complimentary, methods or approaches. 4. Encouraging effective and concrete public participation.

  6. Health Promotion Action Means: Build Public Health Policy Create Supportive Environments Strengthen Community Actions Develop Personal Skills Re-orient Health Services Moving into the future

  7. THE TRIAD OF HEALTH PROMOTION HEALTH EDUCATION HEALTH PROTECTION DISEASE PREVENTION

  8. The Health Promotion Triad Health Education Health Protection Prevention

  9. DISEASE PREVENTION THREE LEVELS Primary Secondary Tertiary

  10. Primary Prevention Secondary Prevention Tertiary Prevention Cure Chronic disease Biological onset of disease Clinical Course of disease Healthy individual Disability Death Functional Status Risk Factors Asymptomatic signs Symptoms and signs Rehabilitation Support Immunization Health Education Prophylaxis Screening Surveillance Diagnosis Treatment Compliance Adherence The Phases of Prevention in relation to natural history of disease

  11. Health Promotion Context: Place of Health Education in Public Health

  12. HEALTH PROMOTION MODELS THREE SPHERES Health Education Prevention Health Protection SEVEN DOMAINS 1. Prevention 2. Lifestyle 3. Preventive Policies 4. Policy Maker Education 5. Health Education 6. Health Protection 7. Policy Support

  13. Health Promotion (Ottawa Charter) Process of enabling people to increase control over, and to improve, their health . health promotion is not just the responsibility of health sector, but goes beyond healthy life styles to well being Health Promotion concept recognizes the role of socio-political environment, public policies, health system and access to care, physical environment, culture, and health related attitudes and behaviors towards health and diseases. Health Education targets health related beliefs, attitudes and behaviors of individuals and populations. Therefore, while Health Education plays an important role there is a need to understand that a larger role is played by national policies, social context, cultural values, health system access 13

  14. Health Promotion Framework Advocacy to make political, economic, social, environmental, cultural, behavioral & biological factors favorable to health. Enable people by ensuring equal opportunities associated text refers to opportunities for access to information, life skills, and making health choices (HEALTH EDUCATION contributes to achieving this goal) -- [and this enables person to take action] Mediate a coordinated action by government, health, social and economic sectors, NGOs, Industry, professional & social groups 14

  15. Health Promotion Actions Healthy Public Policies -- for healthier goods & services, healthier environment, equal opportunities Creation of Supportive Environment Environment - Social, Physical Work, Community, Society levels Strengthening Community Actions Community participation, empowerment, action. Health Education also helps in empowering people for effective participation and taking part in actions which make positive changes to environment, health care services, policies 15

  16. Health Promotion Actions (contd.) Develop Personal Skills By education, information, training Reorient Health Services Health sector must move in a HP direction beyond clinical Respect cultural needs 16

  17. Targets of health education: definitions Health Behaviour: Activity undertaken for the purpose of prevention of diseases, or detecting these at an early stage, or managing them effectively Belief: A statement or body of statements held to be true by an individual or group. Attitude: Position, disposition, or manner with regard to a person or thing 17

  18. AIMS OF HEALTH EDUCATION: 1. To develop a sense of responsibility for health conditions, as individuals, as members of families & communities. (Promotion ,prevention of disease & early diagnosis and management ). While, as mentioned previously, environment, policy, social context plays a major role towards shaping the health attitudes and behaviors, information, knowledge and skills at personal level are also important to adopt healthy behaviors 2. To promote and wisely use the available health services. 3. To be part of all education, and to continue throughout whole span of life.

  19. Process of health education: Dissemination of scientific knowledge about how to promote and maintain health), lead to changes in the Knowledge, Attitudes, and Practices (behavior) related to such changes.

  20. Steps for adopting new ideas & practices : AWARENESS (Know about new ideas) INTEREST (Seeks more details ) EVALUATION (Advantages versus disadvant.+ testing usefulness ) TRIAL(Decision put into practice) ADOPTION (person feels newidea is good and adopts it)

  21. Contents of Health Education RISK FACTORS: e.g. smoking, drugs, road traffic accident risks HEALTH ENHACING PRACTICES: e.g. exercise, nutrition OCCUPATIONAL FACTORS: Safety, Hygiene INFECTION CONTROL: e.g. hand washing CHRONIC ILLNESS, MENTAL HELATH: Knowledge about risks, improvement actions such as promoting togetherness SEXUAL HEALTH i.e. information about STI HEALTH SERVICES: Information about access, Awareness about the need to use the health services SPECIAL GROUPS (food handlers, occupations, mothers, school health)

  22. Principles of Health Education Interest Participation Motivation Comprehension Proceeding from the known to the unknown Reinforcement through repetition Good human relations People, facts and media: knowledgeable, attractive , palatable & acceptable .

  23. Principles of Health Education Learning by doing: If I hear, I forget If I see, I remember If I do, I know . Motivation i.e. awakening the desire to know and learn: - Primary motives, e.g. inborn desires, hunger - Secondary motives, i.e. desires created by incentives such as praise, love, recognition, competition.

  24. Health Education: Individuals About For example, for Healthy behaviors (e.g. breast feeding), secondary prevention Settings where education is imparted Health care settings, Home, Video/Internet Approaches to health education for individuals Risk assessments in various settings Information, contract, evaluation for behavior change Methods for health education for individuals Information provision in-person, print/electronic media Issues High Cost, Focus on Disease rather than on health 24

  25. Health Education: Groups About Behavior change, supportive environment, community action, access to care Settings Health care settings, community, workplace Approaches Knowledge & skill development Peer learning Training for behavior change Methods Didactic & experiential methods Issues Difficult to comprehend and manage group dynamics, difficult to achieve skills to facilitate groups 25

  26. Communication in health education: Education is primarily a matter of communication, the components of which are: CHANNELS AUDIENCE MESSAGE - Individual - Conform with - Educator - Media - Group objectives. ----------------------------------------------------------------------------------------- - 2 way- Public - understandable - needs+ interest of audience ----------------------------------------------------------------------------------------- - 1 way- Public- Acceptable - ? Content of message ----------------------------------------------------------------------------------------- COMMUNICATOR

  27. Evaluation of health education programs: There should be continuous evaluation. Evaluation should not be left to the end but should be done from time to time for purpose of making modifications to achieve better results.

  28. EVALUATION CYCLE: Describe problemDescribe programState goalsDetermine needed information Modify programEstablish basis for proof of effectiveness Analyze &compareOrganize dataDevelop& testDetermine data results baseinstruments collecting method

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