Chapter 10 Health Education PDF

Chapter 10 Health Education  Health Education  Vital health component (individual or community)  Lifestyle changes: applicable to both primary prevention and chronic diseases  Knowledge is key to change  Healthy lifestyles lead to reduced health costs  Healthy Peop...

Chapter 10 Health Education  Health Education  Vital health component (individual or community)  Lifestyle changes: applicable to both primary prevention and chronic diseases  Knowledge is key to change  Healthy lifestyles lead to reduced health costs  Healthy People 2030 supports increased health literacy and health equity  Nurses play key role in education which, in turn, promotes Healthy People 2030 goals 2  Disparities and Empowerment  Health disparities: systematic (avoidable) health differences that adversely affect socially disadvantaged groups  Empowerment: belief one can make a difference in one’s health 3  Health Education  Definition: any combination of planned learning experiences designed to help individuals improve health by increasing knowledge or influencing attitudes (WHO)  Key components  Teaching-learning strategies  Learners maintain voluntary control to change  Focus on behavior change known to improve health 4  Goals of Health Education  Change health behaviors Encourage positive, informed changes in lifestyle Empower the individual  Improve health status Prevent acute and chronic disease Decrease disability Enhance wellness  Also intended to support social and political agenda to promote community health 5  Nursing and Health Education  Health education includes facilitating health- related behavior change  ANA: Health teaching and health promotion is a primary nursing responsibility  Health counseling based on individual interests  Informed consent requires knowledgeable pts  Health-education principles provide tools and strategies to assess readiness; facilitate change 6  Health Literacy  Health literacy: degree to which individual have capacity to obtain (understand) health info to make appropriate decisions (USDHHS)  Nurses have key role in promoting health literacy  Majority of persons have deficient health literacy  Only 12% of US adults have proficient health literacy  Lowest levels: lower education levels, ethnic and racial minorities, uninsured, publicly insured, elderly 7  Strategies for Health Education  Implement universal precautions to literacy  Assume all persons at risk of not understanding  Use plain language, common everyday words  Use teach-back method  Show and explain how to do something  Ask learner to explain in own words the information  Re-explain and re-check if necessary 8  Key Concepts  Health Disparities: Systematic health differences affecting disadvantaged persons  Race, ethnicity, sex, socioeconomic status, age, etc.  Any factor causing discrimination and marginalization  Quality and Safety is essential component healthcare  Use person-centered strategies  Culturally competent care  Empowerment: patients involved in decision- making more likely to make changes 9  Learning Assumptions  Fundamental to planning successful health education  Consider  Developmental stage  Cognitive level  Individual interests  Children need special planning 10  Family Health Teaching  Family: unit in which health values, habits, and risk perceptions are developed  Goal: help members achieve optimal states of health  Guidance through problem-solving and decision-making  Teaching strategies  Directed toward specific area under broad goals  Involves all family members; individualized  Children, adolescents, elderly pose special challenges 11  Challenges to Health Education Children, adolescents, and the elderly may pose special challenges to the nurse 12  Health Behavior Change  Ecological model: health behavior viewed as complex interaction of individuals with environment —multiple influences  Health behaviors: activities which enhance health, prevent disease, control symptoms  Models of health strive to explain factors with influence and/or interfere with health  Health Belief Model  Social learning theory  Transtheoretical Model 13  Health Belief Model  Paradigm to predict and explain health behavior  Components provide guidelines for nurse  Individual perceptions of susceptibility to disease  Perceived seriousness of disease  Perceived benefits of health action  Perceived barriers to health action  Cues that promote action (feelings or media)  Perceived ability to perform the action  Guides nurse to choose effective educational strategies 14  Social Cognitive Theory  Emphasizes the influence of efficacy belief on health behavior  Self-efficacy: individual’s belief in ability to influence his own health  Includes roles of reinforcement and observational learning in explaining health behavior  Modeling  Provides opportunities for imitating behaviors  Useful to demonstrate desired behaviors  Example: parents model behavior for child 15 Transtheoretical Model of Change  “Stages of change model”  Determine where person is re behavior change  Readiness for change  Respect the person’s right to choose  Stages  Precontemplation: not considering behavior change  Contemplation: seriously considering specific behavior change in next 6 months  Planning: starting to change or seriously thinking about making change in next month  Action: made behavior change; change persisted for 6 mo Maintenance: 6 months after change; continues indefinitely 16  Strategies to Facilitate Change  Assess behavior  Education about need for/benefit of change  Motivate using personalized messages  Assess/increase self-efficacy  Decrease barriers to change  Modify behavior  Maintain behavior change 17  Ethics  Respect for human dignity  Right to autonomy or self-determination  Avoid victim blaming  Apply principles of respect, justice, beneficience  Choices belong to individual not provider  Mutually agreed-upon goals  Facilitate informed choices 18  Genomics and Health Education  New opportunities for health education  Ability to target specific population interventions  Facilitate screening and testing  Include information about and implications of technologies into educational programs.  Incorporate genetic and genomic technologies into nursing practice 19 Computer technology and the internet provide new venues for learning 20  Health Teaching Models  Social Marketing Model  Application of marketing principles to create social & behavioral change – tailored to a specific population  Goal? Who has power over goal?  Who do individuals listen to? How to get message across? Examples: gun safety, seat belt, drug abuse  Diffusion of innovations  How an idea or product is adopted and spreads through social system  Address factors that support or inhibit adoption of interventions to improve community health 21  Teaching Plan  Follows marketing and administrative plans  Time, available resources, adequate participants  Key components (teaching strategies)  Desired behavior change for health promotion  Plan written from learner’s perspective  Individual is an active participant  Plan should clarify learner outcomes  Specific actions or abilities desired during or at end of program 22  Assessment  Determine learner characteristics and learning needs  Age, developmental stage, level of education  Health beliefs  Motivation, readiness to learn  Health risks and problems  Current knowledge and skills  Barriers and facilitators to learning  Assess learner’s capabilities, knowledge base, motivation, barriers and facilitators to change 23  Assessment of Learner  What are characteristics and learning capabilities of learner?  What are learners needs for health promotion, risk reduction or health problems?  What does person already know? Skills?  Is learner motivated to change any unhealthy behavior?  What are the barriers to and facilitators of health behavior change? 24  Determining Expected Learning Outcomes  Outcomes driven by public health, societal, and participant goals  Program goals: long-range expected outcomes  Learning goals are established jointly  Identify desired health behavior or status  Learning objectives  Steps to be taken by learner  Should be behavioral  Use action verb  State what to be done, under what conditions, at what level 25  Selecting Content  Three domains of learning  Cognitive: new facts, concepts, build on knowledge  Psychomotor: developing physical skills  Affective: recognition of values, beliefs, relationships, attitudes  Select content to meet behavioral objective  Learning objectives – measurable, observable  Wrong: Pt to understand correct foods re low fat diet *  Correct: Pt will select correct foods from options … * can’t measure or observe “understanding” 26  Designing Learning Strategies  Select methods and tools; structure activities  Teaching strategies  Lecture—present large amount of information  Discussion—interaction between teacher/learners  Demonstration/practice—learn psychomotor skills  Simulation—allow to practice responses to challenging situations 27 Considerations for Selecting Methods  Foster self-directed learning as first priority  Active participant learns more  Methods vary per population, program goals  Create sense of preparedness/organization  Anticipate needs of group  Nurse’s assessment of individual/group learning  Maintain high level of motivation, individual attention, progression  Work with group to maintain learning climate 28  Learning Climate  Prepare and organize: facilities, AV, handouts, attire  Anticipate needs of group: communicate info  Assess individual and group needs  5 effective teacher characteristics: expertise, empathy, enthusiasm, clarity, cultural responsiveness  Maintain high level of motivation, individualized attention and progression  Maintain learning climate:  Observe group interactions, dynamics, participation 29  Evaluating the Teaching-Learning Process  Strategies for evaluation  Written or oral testing  Demonstrations  Observation  Self-reports  Self-monitoring  Evaluation improves subsequent programs  Statistics may reveal program’s impact on public health goals  Refer to other resources for continuing education 30  Teaching and Organizing Skills  Nurses need to learn teaching and organizing skills in health education  Use self-assessment, goal, and intervention process for own skill development  Evaluate skill progress after programs, determine new self-goals for learning teaching skills 31