Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. A Background for the Profession Chapter 1

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Health Education: An Emerging Profession n Somewhere between a discipline & a profession n Discipline – “a branch of knowledge or learning” (Agnes, 2001, p. 410) n Profession – “the sociological construct for an occupation that has special status” (Livingood, 1996, p. 421)

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. A Profession? n A profession (Feeney & Freeman, 1999) –Prolonged training –Accredited institutions & entry requirements –Specialized knowledge & expertise –Standards of practice –Autonomy –Serving social value –Code of ethics n Health Education –Not in agreement –No requirement for such –Synthesized from other disciplines –Yes –This is emerging –Yes

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Professionals (Greene & Simons-Morton, 1984, p. 388) n They believe in what they are doing. n They want to see a job done properly. n They do their best. n They feel a sense of responsibility for the quality of work done by others in the field.

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Current Status of Health Education n More visible today than ever before n More widely accepted by other health professionals n Much notoriety came with beginning of the health promotion era of public health in 1974 n Healthy People report in 1979; behavioral risk factors became more important n 21st Century – “Behavioral patterns are the single most prominent domain of influence over health prospects in the United States” (McGinnis et al., 2002, p. 82).

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Health defined… n “The state of complete mental, physical and social well being not merely the absence of disease or infirmity” (WHO, 1947) n A resource for everyday living, not the object of living (WHO, 1986) n Many dimensions – physical, mental, social, spiritual

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Health Education… “any combination of planned learning experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire information and the skills needed to make quality health decisions” (Joint Committee, 2001, p. 99)

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Health Promotion… “any planned combination of educational, political, environmental, regulatory, or organizational mechanisms that support actions and conditions of living conducive to the health of individuals, groups, and communities” (Joint Committee, 2001, p. 101).

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. The Relationship Between Health Education and Health Promotion (McKenzie, Neiger, & Smeltzer, 2005, p. 4)

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Other Key Terms n Community health n Public health n Coordinated school health program n Wellness

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Measuring Health or Health Status n Epidemiology – “the study of the distribution and determinants of diseases and injuries in human populations” (Mausner & Kramer, 1985, p.1). n Epidemiological data & terms –Rates: crude, adjusted, specific –Terms: morbidity, mortality, endemic, epidemic, pandemic

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Measuring Health (con’t.) n Various measures –Life expectancy: at birth, at 65, at 75 –Years of Potential Life Lost (YPLL) –Disability-Adjusted Life Years (DALYs) –Disability-Adjusted Life Expectancy (DALE) –Health-Adjusted Life Expectancy (HALE) –Health-Related Quality of Life (HRQoL)

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Measuring Health (con’t.) n Health Surveys –Conducted by the National Center for Health Statistics (NCHS) National Health Interview Survey (NHIS) National Health and Nutrition Examination Survey (NHANES) National Hospital Discharge Survey (NHDS) National Hospital Ambulatory Care Survey (NHACS) –Conducted by the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance Survey (BRFSS) Youth Risk Behavior Surveillance System (YRBSS)

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Underlying Concepts of the Profession n The Health Field Concept (Lalonde, 1974) –Human biology (heredity) (19.8%) –Environment (20.1%) –Health care organization (10%) –Lifestyle (health behavior) (51.5%)

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Goal of the Profession “is to promote, maintain, and improve individual and community health. The teaching-learning process is the hallmark and social agenda that differentiates the practice of health education from other helping professions in achieving this goal.” (NCHEC, 1996, pp. 2-3)

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Hierarchy of Objectives (McKenzie, Neiger, & Smeltzer, 2005, p. 131) TypeProgram outcomeType of Evaluation n Process/Admin.Activities & tasksProcess (formative) n LearningAwareness, Impact (summative) knowledge, attitudes, & skills n Action/BehavioralBehavior changeImpact (summative) n EnvironmentalEnvironmental changeImpact (summative) n Program Change in QOL, Outcome (summative) health status, risk, social benefits

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. The Practice of Health Education n Steps for program planning (McKenzie et al., 2005) 1.Understanding the community and engaging the priority population 2.Assessing the needs of the priority population 3.Setting the goals and objectives 4.Developing an intervention that considers the peculiarities of the setting 5.Implementing the intervention 6.Evaluating the result

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Underlying Concepts of the Profession (con’t.) n Levels of Prevention

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Underlying Concepts of the Profession (con’t.) n Risk Factors – those inherited, environmental, & behavioral influences capable of provoking ill health with or without previous disposition –Types Modifiable (changeable or controllable) Nonmodifiable (nonchangeable or noncontrollable) –Examples for heart disease Tobacco use, high BP, elevated cholesterol, diet, diabetes, obesity, lack of exercise, alcohol use, biological factors

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Underlying Concepts of the Profession (con’t.) n Health Risk Reduction –Communicable diseases The Chain of infection –Pathogen, human reservoir, portal of exit, transmission, portal of entry, establishment in new host Environment Host Agent Communicable Disease Model

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Underlying Concepts of the Profession (con’t.) n Health Risk Reduction (con’t.) –Noncommunicable diseases Multicaustion Disease Model Environmental conditions Genetics Medical care Behavioral choices Social circumstances

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Underlying Concepts of the Profession (con’t.) n Causes of death –Leading causes of death: heart disease, cancer, stroke, etc. –Actual causes of death: tobacco, poor diet and physical inactivity, alcohol consumption, etc.

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. Underlying Concepts of the Profession (con’t.) n Other Selected Principles –Participation - active involvement –Ownership - responsibility for –Ecological - environmental circumstances –Population-based approaches - group approaches –Advocacy - alter public opinion –Empowerment - gaining control over own life –Cultural sensitivity - having & showing respect for –Cultural competence - work effectively with other cultures

Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings. A Background for the Profession Chapter 1 – The End