ch 19 Health Education Principles Applied in Communities, Groups, Families, and Individuals for Healthy Change

groups are an affective and powerful medium to

initiate change and implement changes for individuals, families, organizations, and the community

intervention to mitigate covid19

-hand washing -mask -social distancing -vaccination

how people learn

-hearing message -observing -participating learners accept info based on the following: -What they already know? -what they believe? -the culture in which they were raised? -how well they understand? -how well they relate to the info?

evaluation of the educational process

-systematic and logical method for making decisions to improve the health promotion project -educator evaluation, peer, and self -process evaluation

health belief model notes

-theory based off of values and motivation of individual -explains behavior change -made by social psychologists in 1950s to investigate why prevention and disease detection efforts were not working -6 constructs 1. perceived susceptibility (how harmful is it? risk factors?) know they could be exposed to STI 2. perceived severity (how serious, consequences?) risk of contracting STI is severe enough that will avoid getting it to not pay for expensive treatment/ pain 3. perceived barriers (cost, unhinges of behavior change, lack of transportation/knowledge, embarrassed) 4. cues to action (make person feel the need to take action. motivation. advertisement, flyer) 5. self-efficacy (ability to believe they can achieve. go to appt in future or recognize STI) 6. perceived benefits (free screenings. what they believe to be the benefit of stopping the behavior) person believes STI is beneficial. -can be used to promote vaccination, condoms, etc -predicts behaviors based on 6 constructs -used for program development

population considerations when identifying target group

1. age and generation specific strategies 2. health literacy 3. level of health knowledge (pedagogy and andragogy) 4. culture-specific factors (by 2050, 1/2 of US will be ethnic minorities. cultural competence is essential in presenting written, audio, or visual info)

affective domain

1. attitude changes and development of values 2. nurses's attitudes and values my differ (listen carefully) 3. difficult to change deeply rooted attitudes, beliefs, interests, and values 4. 6 steps to change (receive, respond, values, analyze, synthesize, adopt)

how might nurses help established groups to work toward community goals?

1. building cohesion through clarifying goals and individual attraction to groups 2. building member commitment and participation 3. keeping the group focused on the goal 4. maintaining members through recognition and encouragement 5. maintaining member self-esteem during conflict and confrontation 6. analyzing forces affecting movement toward the goal 7. evaluating progress

developing effective health education programs

1. clear message 2. non distracting environment 3. clear language 4. tailored learning format

conflict: negative group dynamics

1. complaints about the degree of member participation 2. dissatisfaction about demands on their schedules 3. complaints about lack of administrative support 4. lack of a work plan for accomplishing the task 5. vying for leadership

how to identify needs and develop goals and objectives

1. conduct a thorough needs assessment -prioritize the needs -consider learner's knowledge, skill, motivation, and available resources -consider barriers to learning 2. develop goals and objectives -goal: broad, long-term expected outcomes -objectives: specific, short term criteria to be met

Implement the Educational Plan

1. control over starting, sustaining, and stopping each method and strategy in the most effective and appropriate time and manner 2. coordination and control over environmental factors, the flow of the presentation, and other contributory facts of the program 3. keeping the materials logically related to the core theme and overall program goals Educators must be flexible and modify educational methods and strategies to meet unexpected challenges that confront both the educator and the learner.

stages of group development

1. forming 2. storming 3. norming 4. performing 5. adjourning

9 basic sequences of instructions

1. gain attention 2. inform learner of objectives 3. stimulate recall of prior learning 4. present the material 5. provide learning guidance 6. illicit performance 7. provide feedback 8. assess performance 9. enhance retention and transfer of knowledge

skills of the effective educator

1. gain learners' attention 2. tell learners the objectives 3. ask learner to recall prior learning 4. present essential material 5. help learners apply info 6. invite learners to demonstrate learning 7. provide feedback

nursing steps to develop a community-based health education program

1. identify a population-specific learning need 2. select one or more learning theories to use 3. consider which educational principles are most likely to increase learning 4. examine educational issues, identify barriers to learning, and choose the most appropriate teaching and learning strategies 5. design and implement the educational program 6. evaluate the effects of the educational program

the educational process

1. identify educational needs of target group 2. establish educational goals and objectives 3. select appropriate educational methods 4. implement the educational plan 5. effectiveness evaluation of teaching

Thomson's steps to understand and managing organizational change (2010)

1. identify the need for change, and this means the client or clients being served need to believe that they need to make a change 2. plan how to implement the change, and this includes explaining the basis for the change, the benefits of the change and seeing ideas from those being served about the best way to make an identified change 3. implement change

box 19.1 steps of a needs assessment

1. identify what the client wants to know 2. collect data systematically about learning needs, readiness to learn, and barriers to learning 3. analyze assessment data that ave been collected and identify cognitive, affective, and psychomotor learning needs 4. think about what will increase the client's ability and motivation to learn 5. assist client to prioritize learning needs

cognitive domain

1. includes memory, recognition, reasoning, understanding, application, and problem solving 2. hierarchical classification of behaviors 3. first step: assess cognitive abilities (literacy and health literacy) 4. six components

name the 6 components of cognitive domain

1. knowledge: requires recall of info 2. comprehension: combines recall with understanding 3. application: new info is taken in and used in a different way 4. analysis: breaks down communication into parts to understand both parts and relationship to one another 5. synthesis: builds on first four levels by assembling then into new whole 6. evaluation: learners judge the value of what has been learned

name 6 steps learner takes in affective domain

1. knowlege: receives info 2. comprehension: responds to info received 3. application: values the info 4. analysis: makes sense of info 5: synthesis: organizes info 6: eval: adopts behaviors consistent with new values

select appropriante educational methods

1. match to strengths and needs (of client and presenter) 2. provide variety 3. incorporate new forms of info (social media, consider privacy issues) 4. consider age, gender, culture, sensory abilities, knowledge level, and size of group

2018 Cape G county public center health priorities

1. mental health 2. wellness and prevention 3. substance abuse 4. obesity 5. smoking 6. dental health 7. chronic disease care 8. access to healthcare (& transportation)

psychomotor learning depends on learners' meetings the following three conditions:

1. necessary ability: have both cognitive and psychomotor ability. 2. sensory image: of how to carry out skill. ask women to describe kitchen and how they would go about the cooking process 3. opportunities to practice: the new skills. provide practice during program

psychomotor domain

1. neuromuscular coordination and motor skills 2. first demonstrate, then practice (inc classroom, may benefit from observing first) 3. three conditions: necessary ability, sensory image, opportunities to practice

the educational product, or the outcome of the educational process can be measured in two ways

1. qualitatively: how well does the learner appear to understand the content? 2. quantitatively: how much of the content does the learner retain? Feedback to the educator provides an opportunity for the educator to modify the teaching process and enables the educator to better meet the learner's needs. Process evaluation examines the dynamic components of the educational program. It follows and assesses the movements and management of information transfer, and attempts to make sure that the objectives are being met.

adults are motivated to learn when

1. they think they need to know something 2. the new info is compatible with prior life experiences 3. they value the person providing the info 4. they believe they can make any necessary changes that are implied by the new info

feilding (2013) offers a similar approach toward health education (to thomson) with these 5 steps

1. understand problem 2. understand what works 3. agree on approach or action 4. implement plan 5. evaluate effect

evaluation of health and behavioral changes

1. variety of methods and tools 2. outcomes measured 3. short term and long term evaluation Variety of approaches, methods, and tools can be used: •Questionnaires •Rating scales •Surveys •Checklists •Skills demonstrations •Testing •Subjective patient feedback •Direct observation of improvements in patient mastery of materials Evaluation of outcomes measured includes changes in knowledge, skills, abilities, attitudes, behavior, health status, and quality of life.

the easiest thing to change is

knowledge -changing attitudes is the next step

andragogy

learning strategies for adults, older adults, and individuals with some health-related knowledge about a topic

pedagogy

learning strategies for children and individuals with little knowledge about a health-related topic

learner-related barriers to learning

low heart literacy lack of motivation to learn info lack of motivation to make needed behavioral changes

theory of planned behavior notes

Constructs: 1. attitude toward act or behavior 2. subjective norm (everything around person. social network, Norms, group beliefs) 3. perceived behavioral control (how easy or hard) predicts that a positive attitude toward act, favorable social norms, high level of perceived behavioral control are best predictors for creating behavioral intention which leads to behavior if one construct is unfavorable, you are less likely to fulfill it. even more so with more unfavorable constructs. ex: buying a phone

precaution adoption process model notes

Decision to act for or against a health decision behavior. stages 1. awareness 2. health belief (need to believe it is important) 3. my susceptibility (have to believe that there is a good chance it can effect you) Decision to act or not takes you down 2 different paths -follow through action after decision making -last stage is maintenance after action these need to be met before you make a decision. any point it can be changed. no one in neighborhood is affected so I don't need to do it. or 4/5 are so I should do this. "stages need to be met almost in that order" similar to trans theoretical model

What a person hears is filtered through his or her past experiences; the social groups to which the person belongs; the person's assumptions, values, level of attention, and knowledge; and the esteem with which he or she holds the person communicating the information.

What a person hears is filtered through his or her past experiences; the social groups to which the person belongs; the person's assumptions, values, level of attention, and knowledge; and the esteem with which he or she holds the person communicating the information.

stages of change notes (trans theoretical model)

a persons readiness to change stages 1. pre-contemplation (not worried about alcohol use, even if others are) benefits outweigh consequences 2. contemplation (still enjoy using, starting to notice problems, what change might they need?) 3. preparation (not so good things about it are outweighing what they enjoy about it. preparing to make change) 4. action (started to make change. might include using less or stopping) 5. maintenance (maintain change, been in action stage for long enough that it is easy) no longer have constant triggers 6. relapse (or lapse) (return back to using. lapse is a slip up. lapse does not automatically lead to release. these provide person with change to learn about themselves) identify where person is at in process to figure out how to support them ppl learn more from setbacks than successes

education

an activity undertaken or initiated by one or more agents that is designed to effect changes in the knowledge, skill, and attitudes of individuals, groups or communities -emphasis the provider of knowledge and skills

The National Academies of Sciences, Engineering, and Medicine define health literacy as

as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." Talking out loud about any health concerns is also important. Patients need the ability to talk about their health concerns and to accurately describe any symptoms. Asking the right questions and understanding medical advice is part of health literacy, said NN/LM. chronically ill and elderly most at risk also affects economy

performing stage

begin to trust one another, interaction takes on more depth. -group uses interpersonal structure to accomplish its goals, and group energy is directed toward tasks

the most difficult thing to change is

behavior

What are the three domains of learning?

cognitive, affective, psychomotor each domain has behavioral components that form a hierarchy of steps, or levels. each level builds on previous

learning

emphasize the recipient of knowledge and skills and the person in whom a change is expected to occur. -involves change

storming stage

express own individuality. which may counter to that of others. often express hostility to one another and polarize due to interpersonal issues.

adjourning

group separates from one another

formal groups

have a defined membership and a specific purpose. they may or may not have an official place in the community's organization

change

means to move away from one way of thinking, believing, and acting and move toward a new way

forming stage

members become acquainted with one another and attempt to understand the nature of their task -try to determine their behaviors in relation to one another and goal of group

norming stage

members start to accept one another; develop some cohesion, norms, and roles; and become comfortable in expressing their opinions and offering ideas

informal groups

multiple ties. the purposes are unwritten yet understood by members -form spontaneously and when participants have a common interest or need

a major health care reform goal is to

reduce costs One way to do so is to help people stay healthy and to reduce illness and disability. Nurses can play a key role in this aspect of health care reform by teaching individuals, families, groups, and communities how to promote better health.

the best approach to conflict in a group is

to match the response style to the situation, which requires personal awareness and awareness of others

community groups may be formal or informal

true

a sample of objectives for health education (healthy people 2020)

•ECBP-2: Increase the proportion of elementary, middle, and senior high schools that provide comprehensive school health education to prevent health problems in the following areas: unintentional injury; violence; suicide; tobacco use and addiction; alcohol or other drug use; unintended pregnancy, HIV/AIDS, and STDs; unhealthy dietary patterns; and inadequate physical activity. •ECBP-3: Increase the proportion of college and university students who receive information from their institution on each of the priority health-risk behavior areas listed above. •ECBP-8: Increase the proportion of worksites that offer a comprehensive employee health promotion program to their employees. •ECBP-11: Increase the proportion of local health departments that have established culturally appropriate and linguistically competent community health promotion and disease prevention programs.

educator related barriers to learning

•Fear of public speaking •Lack of credibility with respect to a certain topic •Limited professional experiences related to a health topic •Unable to deal with difficult people •Lack of knowledge about how to gain participation •Lack of experience in timing a presentation •Uncertain about how to adjust instruction •Uncomfortable when learners ask questions •Want to obtain feedback from learners •Concerned about equipment functioning properly •Difficulty with openings and closings •Overly dependent on notes