1. J. Gaspar CSULA Student Health Center Quality Health Education Responding to Client Needs

2. J. Gaspar CSULA Student Health Center Presentation Objectives Identify the leading causes of death and their risk factors Describe the role of health education in relation to self- actualization achievement Discuss strategies for ensuring the delivery of quality health education Describe CSULA Student Health Center health education services

3. J. Gaspar CSULA Student Health Center The Link between Behavior and Health

4. J. Gaspar CSULA Student Health Center Leading Causes of Death & Their Risk Factors Leading causes of death (United States, 2005)* Heart Disease: 652,091 Cancer: 559,312 Stroke (cerebrovascular diseases): 143,579 Chronic lower respiratory diseases: 130,933 Accidents (unintentional injuries): 117,809 Diabetes: 75,119 Alzheimer’s disease: 71,599 Influenza/pneumonia: 63,001 Nephritis, etc.: 43,901 Septicemia: 34,136 Risk factors Behaviors, attitudes & beliefs, health conditions, socioeconomic status, environmental influences and other factors that may negatively impact health status Lifestyle (i.e., behavior) is the primary risk factor for the 20 top killers  Inactivity, poor diet, behaviors that cause accidents, unsafe sex, etc. *National Center for Health Statistics (CDC) Leading Causes of Death in Children and Adolescents Accidents Heart disease Cancer Homicide Birth defects Suicide

5. J. Gaspar CSULA Student Health Center Personal Health

6. J. Gaspar CSULA Student Health Center Health and Wellness Health Medical model Absence of death, disease, discomfort, disability, and dissatisfaction Environmental model Health is influenced by environmental factors including socioeconomic status (SES) and physical environment Holistic model Health is a dynamic interaction between an individual’s physical, emotional, spiritual, intellectual, social, and environmental wellbeing

7. J. Gaspar CSULA Student Health Center Personal Health Three central ideas of personal health Good health requires taking responsibility for one’s health and making “deliberate” choices and taking deliberate action to be healthy Self-efficacy  The conviction that a person can successfully change his or her behavior in relation to a desired result  Self-efficacy influences  Target behaviors and situations; Amount of effort given; Length of time devoted to change efforts; Perceptions Good health involves an interaction of the various dimensions of wellness Commitment to good health is a necessary for having a happy, fulfilling, and productive life Health Framework for California Public Schools: Kindergarten Through Grade Twelve (Health Framework)

8. J. Gaspar CSULA Student Health Center Health Literacy Defined as.. “The capacity of an individual to obtain, interpret, and understand basic health information and services and the competence to use such information and services in ways that are health-enhancing.” Key components Acceptance of personal responsibility for lifelong health Respect for and promotion of the health of others An understanding of the process of growth and development Informed use of health-related information, products, and services Health Framework

9. J. Gaspar CSULA Student Health Center Health Literacy Health literate individuals Accept personal responsibility for lifelong health  Committed to healthy living; acknowledge control; apply health knowledge Respect and promote the health of others  Understand and acknowledge: the impact of their behavior on others; influence of individuals on the environment; how the environment can affect health Understand the process of growth and development  Understand and acknowledge common and unique aspects of growth and development; respect others Use health-related information, products, and services in an informed manner  Wise healthcare consumers Health Framework

10. J. Gaspar CSULA Student Health Center Maslow’s Hierarchy of Needs In order to find fulfillment, basic needs must first be met Expanded views Aesthetic needs Spirituality, beauty, balance, form Cognitive needs Knowledge, meaning, self- awareness Transcendentalism Helping others to reach self- actualization Role of health educators J. Gaspar, Kolander et. al. Self-actualization Fulfillment, striving to become everything you are capable of becoming Wellness lifestyle, health literate… Esteem Self-esteem, achievement, respect Self-efficacy… Belongingness Relationships, family, friends Respect, honesty, dependability… Safety Protection, stability, trust Safer sex, violence-free relationships… Physiological Air, water, shelter, food, sleep Knowledge, self-care…

11. J. Gaspar CSULA Student Health Center Ensuring Quality in Health Education

12. J. Gaspar CSULA Student Health Center Education and Credentialing Health education settings Healthcare and social assistance settings (50%) State and local government (20%) Education Entry level minimum requirement is a bachelor’s degree in health education or a related area Master’s degree is preferred or required depending on setting Master of Public Health (MPH) Master of Science, Public Health (MSPH) Master of Arts (MA) or Master of Science (MS) in a related area Doctoral degree required for administrative and tenure track teaching positions Doctor of Public Health (DrPH) Doctor of Philosophy (Ph.D.) Credentialing and certifications Required or preferred depending on setting Certified Health Education Specialist  National Commission of Health Education Credentialing, Inc. Related to job function Bureau of Labor Statistics (U.S. Department of Labor)

13. J. Gaspar CSULA Student Health Center Accreditation Health education standards Services are appropriate for the needs of the population served and includes mechanisms for conducting complete needs assessments Health promotion and education services are provided by qualified personnel with access to appropriate resources Health education programs include clearly defined goals and objectives and evaluation methods Organization has adequate resources for the delivery of health education services Marketing of health education programs accurately reflects services Accreditation Association for Ambulatory Health Care, Inc. (AAAHC)

14. J. Gaspar CSULA Student Health Center Accreditation Health education standards Policies and procedures exist to assess satisfaction with health education services Health education services are documented in the medical record, as appropriate Health education programs should be comprehensive with a holistic view Alcohol and other drugs; healthy eating; physical fitness; sexuality; healthy relationships; violence prevention; stress management Health education should be included in quality improvement activities AAAHC

15. J. Gaspar CSULA Student Health Center Health Education Programming National Cancer Institute Health educators must be able to apply key models and theories to their work

16. J. Gaspar CSULA Student Health Center Health Education Programming National Cancer Institute

17. J. Gaspar CSULA Student Health Center Health Belief Model Perceptions directly influence health behaviors Seriousness of issues Susceptibility to condition Benefits of health promoting change Barriers to health promoting change Cues to action stimulate change Health event, discussion with friends, commercial Social Cognitive Theory Behavior is influenced by expectations and incentives Expectations  How events are connected, consequences of behavior, ability to change (self- efficacy) Incentives for change  Perceived outcome value Theory of Reasoned Action Behavior is influenced by intentions and beliefs Behavioral intentions  Intention strength influences success Attitudes and subjective norms  Attitudes: positive or negative beliefs about performing a particular behavior  Subjective norms: beliefs that important persons believe behavior should be performed/not performed (Inter-)Personal Theories

18. J. Gaspar CSULA Student Health Center Stages of Change (the Transtheoretical Model) Pre-contemplation stage Individuals are uninterested, unaware, or unwilling to make a change  A cue to action stimulates progression to next stage Contemplation stage Individuals are thinking about making a change  Weigh the pros and cons Preparation stage Individuals prepare to implement changes  Set SMART goals; self-assessment; develop a realistic plan; get the support of friends and family; think about solutions to potential barriers Action stage Individuals implement change plans  Revisit your goals and change plan Maintenance stage Individuals are trying to maintain a change  Find fun and creative ways to maintain positive behaviors  Relapse happens – be prepared – Get help (Inter-)Personal Theories

19. J. Gaspar CSULA Student Health Center Making Changes If you’re not thinking about making a change Get educated; do a self-assessment; reevaluate If you have been thinking about it Get more info & weigh the pros and cons If you’re ready to take action Choose a target behavior Select one or two related behaviors to change Set SMART goals to improve your chances of success Specific, Measurable, Attainable/healthy, Rewarding, Time oriented Shaping: Set mini goals and take it one step at a time Develop a realistic plan Map out how you will get from point ‘A’ to point ‘B’ Get the support of friends and family Think about solutions to potential barriers If you’ve started taking action Revisit your goals and change plan Make necessary modifications If you’re trying to maintain a change Find fun and creative ways to maintain positive behaviors Relapse happens – be prepared Get help

20. J. Gaspar CSULA Student Health Center Conclusion

21. J. Gaspar CSULA Student Health Center Do not let what you cannot do interfere with what you can do. John Wooden

22. J. Gaspar CSULA Student Health Center

23. Resources Health education as an occupation Bureau of Labor Statistics, U.S. Department of Labor http://www.bls.gov/oco/ocos063.htm Health education credentialing National Cancer Institute, National Institutes of Health Theory at a Glance – A Guide for Health Promotion Practice  http://www.cancer.gov/theory.pdf http://www.cancer.gov/theory.pdf Health education theory National Cancer Institute, National Institutes of Health Theory at a Glance – A Guide for Health Promotion Practice  http://www.cancer.gov/theory.pdf http://www.cancer.gov/theory.pdf