Chapter 6 Health Promotion with Groups © John Hubley & June Copeman 2013

Important Groups for Health Promotion Teaching/learning groups Self-help groups Problem-solving groups and teams Community-based groups

Effective group functioning depends on group dynamics The characteristics of the group including size and membership The nature of the tasks undertaken The decision-making processes The roles of members Group processes Pattern of leadership Research on group dynamics suggest the following to be important in determining the effectiveness of group functioning: the characteristics of the group including size and membership; the nature of the tasks undertaken; the decision-making processes; the roles of members; group processes; and pattern of leadership. Size of group- The kinds of interactions, opportunities for exchange of ideas and success in achieving objectives are affected by the group size. With too few members, most people will have a chance to contribute, but there will be less experience to draw on from the members. With too many people, it is difficult for everyone to contribute in discussion and harder to reach a shared decision. Many feel that 8-12 persons is an ideal size for a group but it really depends on the aims and purpose of the group. Background of the group members- Who the group members are and their reasons for attending are of enormous importance to the function of a group: Persons may have a 'hidden agenda' and see the function of the group as meeting their own personal needs rather than that of the group. The purpose of the group -and the tasks it sets out to accomplish. Another way of thinking about different kinds of groups is to classify them according to the extent to which they are mainly concerned with producing results (task-oriented) or with promoting the well-being of the members of the groups (process-oriented). The presence or absence of effective leadership- An effective group leader or facilitator can make all the difference. Leadership tasks include those involved with group maintenance – dealing with the well-being of the group, and task maintenance including those directed at helping the group achieve its purpose. You will find more about the leadership styles and functions in the Chapter 16.

Groups are an ideal way for people to learn. Small-group teaching Groups are an ideal way for people to learn. Active learning Be clear Make it meaningful Encourage participation Ensure mastery Give feedback Groups are an ideal way for people to learn because everyone can participate. The principles of adult learning can be applied to group teaching to facilitate an interactive session Active learning: make students think and apply the knowledge through a task Be clear: use visual aids, speak clearly, use simple language Make it meaningful: explain in advance what you are going to teach explain all new words and ideas; relate what you teach to student's lives and work; give example summarize main points at end. Encourage participation: stimulate discussion and involve the group in the learning. Ensure mastery: check understanding and competence reached. Give feedback: tell the learners what their progress is. Taken from Hubley (2003).

A good visual aid In January 2000, Newsweek ran a cover story on AIDS orphans in Africa. The headline read: “10 Million Orphans.” Box 6.3 A good visual aid A visual aid can be a photograph, extracts from a magazine or newspaper, a poster, information on a flip-chart, an overhead projector transparency, PowerPoint presentation, a video. A good visual aid: Explains complex ideas. Gains attention and holds interest. Triggers discussion. Creates a shared experience. Makes key points memorable. Is relevant to the session. Is clear and without distracting content. 2

Types of Learning in Group Facilitation Facts Decision-making skills Communication skills Practical/manual skills (Psychomotor skills) Attitudes and values (feelings) Facts may be simple; or complex , familiar or new, compatible or in conflict with existing knowledge. Decision-making skills involve application of knowledge to make decisions coving personal and family life or ones professional role. Communication skills verbal and non-verbal skills involved with giving information, persuading and teaching Practical/manual skills (Psychomotor skills) manipulating and handling objects Attitudes and values (feelings)

Overall approach to assertiveness training Listening to what the other person has to say Saying no Broken record Fog Box 6.5 How to do assertiveness training Assertiveness training involves working in small groups and using a variety of approaches including self examination, case studies, role plays to develop self-awareness and skills in specific techniques for asserting one’s viewpoint without resorting to aggressive responses. The aim is to control your verbal and non-verbal behaviour and avoid aggressive approaches which aggravate the situation further. The overall approach in assertiveness training can be summarized as: Listening to what the other person has to say, show that you understand their point of view, explain how their actions make YOU feel, say that you have needs too that should be respected and explain what those needs are. Saying no. Making it clear that you understand the other person’s position but saying no in a positive way – “I would prefer not to, I would rather not, I don’t want to…..” Broken record. Continuing to repeat your point of view even if the other person tries to change the subject. Fog. Defusing the situation by appearing to agree with the person “Yes, I can see how you must feel about this” – not allowing yourself to be provoked into a negative attacking response, keeping your cool.

Participatory Learning Methods Role Play Board games Discussion posters Trigger videos

Board games

Checklist - planning a group learning session What specific kinds of learning do I want to promote? Factual knowledge Decision-making or problem-solving skills Communication skills Psychomotor (manual) skills Attitudes Box 6.8 How to plan a group learning session You can use the following checklist to plan your group session. What specific kinds of learning do I want to promote during the session see box 6.4. Factual knowledge – specific facts about the health topic that they need to make informed decisions. Decision-making or problem-solving skills – how to make decisions e.g. plan a diet, organize a budget, set objectives for life, choose the best form of exercise. Communication skills e.g. assertiveness, discussing sensitive issues, getting their point across to health workers, communicating with their children etc. Psychomotor (manual) skills e.g. preparation and cooking foods, using a blood pressure monitor, massage techniques, measuring blood sugar level etc. Attitudes e.g. sensitivity to the needs of others, importance of taking regular exercise, diet, talking to your baby etc. How many people should I involve in the group? Who will be the participants? How will I present the information? Will I use a visual aid e.g. overhead projector or PowerPoint? How can I make the presentation interactive to avoid it seeming like a lecture? How will I trigger discussion and participation? Will I use a group task or a trigger video? How will I structure the time in the session? How long will the session last? What will be the balance of time between presentation of information and participatory activities? How much time should I leave for questions and summarizing main points? How will I split up the group into smaller groups? How will I manage the feedback from the group sessions? What kind of follow-up would I want from the session and how can I encourage it? How can I evaluate it? What questions or activities could I include that would tell me what people have learned from the session?

Checklist - planning a group learning session How many people should I involve in the group? How will I present the information? How can I make the presentation interactive to avoid it seeming like a lecture? How will I trigger discussion and participation? How will I structure the time in the session? How much time should I leave for questions and summarizing main points? Box 6.8 How to plan a group learning session You can use the following checklist to plan your group session. What specific kinds of learning do I want to promote during the session see box 6.4. Factual knowledge – specific facts about the health topic that they need to make informed decisions. Decision-making or problem-solving skills – how to make decisions e.g. plan a diet, organize a budget, set objectives for life, choose the best form of exercise. Communication skills e.g. assertiveness, discussing sensitive issues, getting their point across to health workers, communicating with their children etc. Psychomotor (manual) skills e.g. preparation and cooking foods, using a blood pressure monitor, massage techniques, measuring blood sugar level etc. Attitudes e.g. sensitivity to the needs of others, importance of taking regular exercise, diet, talking to your baby etc. How many people should I involve in the group? Who will be the participants? How will I present the information? Will I use a visual aid e.g. overhead projector or PowerPoint? How can I make the presentation interactive to avoid it seeming like a lecture? How will I trigger discussion and participation? Will I use a group task or a trigger video? How will I structure the time in the session? How long will the session last? What will be the balance of time between presentation of information and participatory activities? How much time should I leave for questions and summarizing main points? How will I split up the group into smaller groups? How will I manage the feedback from the group sessions? What kind of follow-up would I want from the session and how can I encourage it? How can I evaluate it? What questions or activities could I include that would tell me what people have learned from the session?

Checklist - planning a group learning session How will I split up the group into smaller groups? How will I manage the feedback from the group sessions? What kind of follow-up? How can I evaluate it? What questions or activities could I include that would tell me what people have learned from the session?