NCM 104 – CHN 1

EDUCATION FOR HEALTH LEARNING MATERIALS

Prepared by: Melissa D. Sarmiento, RN, RM, MSN

EDUCATION FOR HEALTH (HEALTH EDUCATION) AND HEALTH LITERACY

 Health education is an integral part of the nurse’s role in the community for promoting health,
preventing disease, and maintaining optimal wellness.
 Health education is the primary role of the Community Health Nurse.
 The community is a vital link for the delivery of effective health care and offers the nurse multiple
opportunities to provide appropriate health education within the context of a setting that is
familiar to community members.
 Health education is defined as any combination of learning experiences designed to predispose,
enable, and reinforce voluntary behavior conducive to health in individuals, groups or
communities.
 Health Education are increasingly occurring via social media, e-health, and/or internet-based
communication channels, however, at the core of health education is the development of trusting
relationships based on nurturing and healing interactions that heavily rely on community-based
participatory methods.

THEORETICAL UNDERPINNING OF HEALTH EDUCATION

 According to Bigge and Shermis (2004), learning is an enduring change that involves the
modifications of insights, behaviors, perceptions, or motivations.
 In Knowle’s Assumption about adult learners he contends that adults like children, learn better
in a facilitative, non-restrictive, and non-structured environment.
 The Health Belief Model (HBM) is based on social psychology and its purpose was to explain why
people did not participate in health education programs to prevent or detect disease, in
particular, tuberculosis screening programs, (Hochbaum, 1958).
 HBM is a value expectancy theory that addresses factors that promote health-enhancing
behavior; it is disease specific and focuses on avoidance orientation.
 Health Promotion Model by Pender is a competence or approach-oriented model. It brings
together a number of constructs from expectancy value theory and social cognitive theory within
a holistic nursing framework.
 The central focus of HPM is based on individual characteristics and experience, behavior-specific
cognitions and affect, and behavior outcomes that can be assessed by the nurse and that serve as
key points for nursing intervention (Pender, 2015).
 Freire’s a Focus on Problem-Solving Education allows active participation and on-going dialogue
and encourages learners to be critical of and reflective about health issues (Freire, 1970).

GOAL OF HEALTH EDUCATION

 is to understand health behavior and to translate knowledge into relevant interventions and
strategies for health enhancement, disease prevention, and chronic illness management.

AIMS OF HEALTH EDUCATION

 to enhance wellness and decrease disability; attempts to actualize the health potential of
individuals, families, communities, and society, and includes a broad and varied set of strategies
 aimed at influencing individuals within their social environment for improved health and well-
being. (Green and Kreuter, 2005)

STEPS IN HEALTH EDUCATION

 Creating awareness
 Motivation
 Decision-making action

ASPECTS OF HEALTH EDUCATION

 Information
 Education
 Communication

PRINCIPLES OF HEALTH EDUCATION

1. Principle of Educational Diagnosis - involves the identification of the causes of the behavior.
2. Principle of Hierarchy - there is a natural order in the sequence of factors influencing behavior.
3. Principle of Cumulative Learning - experiences must be planned in a sequence that takes into account
the patient’s prior learning experiences and the concurrent incidental learning experiences or
opportunities to which patient may be exposed.
4. Principle of Participation - changes in behavior will be greater if patients have identifies their own
need for a change and have actively selected a method or approach that they believe will enable
them to change.
5. Principle of Situational Specificity - there is nothing inherently superior or inferior about any method
of intervention or patient education but that the effectiveness and efficiency of any disease
management program will depend on the circumstances and the characteristics of the patient
and/or the change agent (physician, nurse educator)
6. Principle of Multiple Methods - comprehensive behavior change programs should employ methods
or components in consideration of the interaction of person-specific and situation-specific
factors.
7. Principle of Individualization - Individualization or tailoring of patient education interventions applies
the principles of participation, specificity and cumulative learning in producing interventions
that are both patient – and – situation relevant.
8. Principle of Relevance - the more relevant the contents and methods used are to the patient’s
circumstances and interest, the more likely the learning and behavior process is to be successful.
9. Principle of Feedback - provision of feedback allows the patient to adapt both the learning process
and the resultant behavioral responses to his or her own situation and pace.
10. Principle of Reinforcement - behavior that is rewarded tends to be repeated.
11. Principle of Facilitation - Involves the degree to which an intervention either provides the means for
patients to take action or reduces the barriers to action.

FACTORS AFFECTING THE ATTAINMENT OF HEALTH EDUCATION

1. Availability and accessibility of health services to which the individual have trust
2. The economic feasibility of putting into practice the health measures being advocated
3. Acceptability of the proposed health practice in terms of their customs and traditions that an
individual observe
QUALITIES OF A GOOD HEALTH EDUCATOR
1. Knowledgeable
2. Credible
3. Good listener
4. Can empathized with others
5. Possess teaching skills
6. Flexible
7. Patience
8. Creative and innovative
9. Effective motivator
10. Able to rephrase and summarize
11. Encourages group participation
12. Good sense of humor
13. Works for the joy of it

HEALTH LITERACY - is about empowerment, that is, having access to information, knowledge, and
innovations.
 is also an essential component of public health goals that aim to create social and physical
environments for good health for all.
 it is a constellation of skills needed to perform basic reading tasks required to function in the
health care environment for accessing, understanding, and using information to make health
decisions.

FRAMEWORK FOR DEVELOPING HEALTH COMMUNICATIONS

STAGE I : PLANNING AND STRATEGY DEVELOPMENT
 Provides foundation for program planning process and is crucial in setting the stage for creating
salient communication
 QUESTIONS TO ASKED:
Who is the intended audience?
What is known about the audience and from what sources?
What are the communication and education objectives and goals?
What evaluation strategies will the nurse use?
What are the issues of most concern?
What is the health issue of interest?
 COLLABORATIVE ACTIONS TO TAKE:
Review available data from health statistics, census data, local sources, libraries, newspapers,
and local or community stakeholders.
Get community partners involved.
Obtain new data (e.g. interview, surveys, and focus groups using problem-posing dialogue
format).
Determine the intended group’s needs and perceptions of health problems (identify audiences).
Determine the community’s assets and strengths:
Physical
Behavioral
Demographic
Psychographics
Identify issues behind health knowledge gaps.
Establish goals and objectives that are specific, attainable, prioritized, and time specific.
 Assess resources (money, staff, and materials)
STAGE II: DEVELOPING AND PRETESTING CONCEPTS, MESSAGES, AND MATERIALS
 this considers how to reach the intended audience and use interesting and engaging supporting
materials and media.
 Channel refers to how the nurse reaches communication sites
 Format refers to how the nurse communicates the health message
 QUESTIONS TO ASK
What channels are best?
What format should be used?
Are there existing resources?
How can the nurse present the message?
How will the intended audience react to the message?
Will the audience understand, accept, and use the message?
What changes can improve the message?
 COLLABORATIVE ACTIONS TO TAKE
Identify messages and materials.
Decide whether to use existing materials or produce new ones.
Select channels and formats.
Develop relevant materials with the target audience.
Pretest the message and materials and obtain audience feedback
STAGE III: IMPLEMENTING THE PROGRAM
 Nurse introduces the health education message and program to the intended audience and
reviews and revises necessary components
 The nurse also analyzes the program and health message for effectiveness.
 QUESTIONS TO ASK
How should the health education program/message be launched?
How do we maintain interest and sustainability?
How can we use process evaluation?
What are the strengths of the health program?
How can we find out whether we have reached the intended audience?
How well did ach step work? (process evaluation)
Are we maintaining good relationships with our community partners? How can we keep on track
within the timeline and budget?
 COLLABORATIVE ACTIONS TO TAKE
Work with community organizations, adult education centers, businesses, media, and other
health agencies to enhance effectiveness.
Monitor and track progress.
Establish process evaluation measures (follow up users of the service, number of community
member who used the service, and expenditures)
STAGE IV: ASSESSING EFFECTIVENESS AND MAKING REFINEMENTS
 The nurse uses outcome evaluation together with the process evaluation
 Outcome evaluation examines whether changes in knowledge, attitudes, and behavior did or did
not occur as a result of the program.
 The nurse prepares for a new development cycle using information gained from audience
feedback, communication channels, and the program’s intended effect.
 QUESTIONS TO ASK
What was learned?
 How can outcome evaluation be used to assess effectiveness?
What worked well, and what did not work well?
Has anything changed within the intended audience?
How might we refine the methods, channels, or formats?
Overall, what lessons were learned, and what modifications could strengthen the health
education activity?
 COLLABORATIVE ACTIONS TO TAKE
Conduct outcome evaluations.
Reassess and revise goals and objectives.
Modify unsuccessful strategies or activities.
Generate continual support from businesses, health care agencies, and other community groups
for on-going collaboration and partnerships.

TIPS FOR EFFECTIVE HEALTH TEACHING

1. Put patient at ease and establish rapport.
2. Assess reading skills using informal and formal methods.
3. Determine what your patient/community member wants to know.
4. Identify motivating factors for learning new information and behaviors.
5. Stick with essentials. Limit the number of concepts or key points.
6. Set realistic goals and objectives.
7. Use clear and concise language.
8. Consider developing a glossary or vocabulary list for common words on the health topic.
9. Space your teaching out over time, if possible incorporate health education activities into other
activities.