Health Education

WHO Health promotion (Glossary 1998)

"Health literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health"

Motivation

"a combination of forces which initiate, direct and sustain behavior"

Health education

"comprises consciously constructed opportunities for learning involving some form of communication designed to improve health literacy, including improving knowledge, and developing skills which are conducive to individual and community health" -WHO health promotion glossary

National conference on preventive medicine in USA

"health education is a process that informs, motivates, and helps people to adopt and maintain healthy practices and lifestyles, advocates environmental changes as needed to facilitate this goal and conducts professional training and research to the same end"

HEALTH PROMOTION

"process of enabling people to increase control over, and to improve health" -Ottawa Charter for Health Promotion, First International Conference on Health Promotion, Ottawa 21 November 1986

CHALK AND TALK (LECTURES)

-"A carefully prepared oral presentation of facts, organized thoughts and ideas by a qualified person" -Should have an opening statement -Group should not be more than 30 people -Duration of talk should not exceed 15-20 minutes -Should be based on topics of current interest Its effectiveness depends on ability of speaker to write and draw legibly Disadvantage-one way communication, learning is passive

MOTIVATION

-"the fundamental desire for learning in an individual" -Health education can be facilitated by the motivation provided by the desire to achieve individual goals -Eg:-for a teenager, esthetics might be a motive to take care of his teeth whereas for an adult, the expenses of undergoing restorative care

ADMINISTRATIVE OR SERVICE APPROACH

-This approach intends to provide all the health facilities to the people with the hope that they will use it -it becomes a failure if the service is not based on the felt needs of the people

GROUP DISCUSSIONS

-A group is an aggregation of people interacting in a face-to-face situation -Process of identifying problems and finding solutions collectively by members of group -Consist of 6-12 members -Participants are seated in a circle -Group leader initiates the subject, prevents side conversations, encourages everyone to participate and sums up the discussion -There should be a recorder who prepares a report on issues discussed and agreements reached

SYMPOSIUM

-A series of speeches on a selected topic -Each speaker presents a brief aspects of the topic -There is no discussion among speakers -In the end, the audience may ask questions -The chairman makes a summary at the end of the session

VISUAL AIDS

-Based on the principles of projection -Helps individuals to understand better -It is of 2 types 1.projected aids 2.non-projected aids

AUDITORY AIDS

-Based on the principles of sound, electricity and magnetism -Useful in reproducing any kind of words spoken and also helps in repeating the same Megaphones Microphones Gramophone records and discs Tape records Radios Sound amplifiers

KNOWN TO UNKNOWN

-Before the start of any health education program, the health educator should find out how much the people already know and then give them the new knowledge. -The existing knowledge of the people can be used as the basic step up on which new knowledge can be placed -Eg:-A health education program with the aim of introducing a toothbrush to a rural population will be better appreciated if the communicator start the program with "what are you using to clean your teeth at present" and then going in to details like "why are you using it" and then connecting it to the tooth brush and then providing details about the

Individual Approach (Advantages)

-Can be done in a dentist's consultation room -Discussion, argument and persuasion of an individual to change his behavior is possible -Opportunity for the individual to ask questions and clearing doubts

MASS APPROACH

-Communication is given to a community where the people gathered together do not belong to one particular group Advantages: -Large number of people can be reached -People of all socio-economic status have access to health education Disadvantage : -One way communication

COMMUNITY LEADERS

-Community leaders can be used to reach the people of the community and to convince them about the need for health education -Leaders can also be used to educate the people as they will have a rapport and will be familiar with the people of their community -The leader will have an understanding of the needs of the community and advice and guide them

PHYSIOLOGICAL BARRIERS

-Difficulties in self expression, hearing, seeing, understanding -Channels of communication should be selective

Non projected aids

-Do not require any projection -Black board -Pictures, cartoons, photographs -Flip charts, flashcards Flannel boards -Printed materials- leaflets, pamphlets, folders, booklets, brochures -Models, specimens

PSYCHOLOGICAL BARRIERS

-Emotional disturbances, depression, neurosis, psychosomatic disorder -Special methods and utmost care should be adopted to convey the message

ENVIRONMENTAL BARRIERS

-Excessive noise, difficulties in vision and congestion -It can be overcome by making small groups and using appropriate channels for communication

One way communication

-Flow of information is one way, from the sender to the receiver. The draw backs are -Knowledge is imposed -Learning is authoritative -There is little audience

CONTENTS OF HEALTH EDUCATION

-HUMAN BIOLOGY -NUTRITION -HYGIENE -FAMILY HEALTH CARE -CONTROL OF COMMUNICABLE AND NON-COMMUNICABLE DISEASES -PREVENTION OF ACCIDENTS -USE OF HEALTH SERVICES

Sender

-He is the originator of the message. -His objectives should be clearly defined. -He should know the interests and needs of his audience. -He should know the message. -He should know the channels of communication. -He should know his abilities and limitation

PARTICIPATION

-Health educator should encourage people to participate in the program -Once the people are given a chance to take part in the program it leads to their acceptance of the program -Methods like group discussion, panel discussions etc. provide opportunities for people's participation

Creating supportive environments for health

-Health promotion generates living and working conditions that are safe, stimulating, satisfying and enjoyable -The protection of the natural and built environments and the conservation of natural resources must be addressed in any health

Developing personal skills

-Health promotion supports personal and social development through providing information, education for health, and enhancing life skills. Eg:-Increasing patient's knowledge about the role of sugar and plaque in the etiology of dental diseases and to develop tooth brushing skills and promote self care

Strengthening community action for health

-Health promotion works through concrete and effective community action in setting priorities, making decisions, planning strategies and implementing them to achieve better health. -At the heart of this process is the empowerment of communities

INTEREST

-If the health education topic is of interest to the people, they will listen to it. -Health educator should identify the "felt needs" of the people and then prepare a program that they can actively participate in to make it

LEARNING BY DOING

-If the learning process is accompanied by doing new things it is better instilled in the minds of people -"if I hear, I forget; if I see, I remember; if I do, I know

WORKSHOP

-It consist of series of meetings with emphasis on individual work with the help of resource persons -Total work shop is divided in to small groups and each groups will select a chairman and a recorder -The individuals work, solve a part of the problem, contribute to group discussions and leave the workshop with a plan of action for the problem

PRIMARY HEALTH CARE APPROACH

-It involves full participation and active involvement of the people starting from the planning stage till the delivery of the health services. -This is based on principles of primary health care-community participation -This can be achieved by providing the necessary guidance to help people identify their health problems and to find solutions to these problems

CREDIBILITY

-It is the degree to which the message is perceived as trustworthy by the receiver -It should be scientifically proven, based on facts and should be compatible with local culture and goals

Feedback

-It is the flow of information from the audience to the sender. -It provides an opportunity to modify the message and render it more acceptable Eg:- opinion polls, interviews, questionnaire surveys

Message

-It is the information transmitted by the communicator to the recipient. -A good message must be: 1. In line with the objective. 2. Based on felt needs. 3. Clear and understandable. 4. Specific and accurate. 5. Timely and adequate. 6.Interesting 7. Culturally and socially appropriate.

Channels of communication

-It is the media used for communication The media chosen should be -Efficient in transmitting the message -Attractive to the audience -Easily understandable by the people -Able to bring about good response and interaction by the people -The most common channel of communication is interpersonal or face-to-face communication

Health education (importance)

-It is vital to the practice of prevention -It is the channel for reaching the people and alerting them to the doctor's services and to all other community health resources -A 'health educated' person is well aware of his own responsibility and of the steps he himself must take to receive the full benefits of prevention at all levels

COMPREHENSION

-Level of understating of the people who receive the health education -Should first determine the level of literacy and understanding of the audience and act accordingly -words that are strange or new to the people should not be used -Use of technical terms or medical -Eg:-A statement saying "Eat food items that are cariogenic" may not be comprehensive to the layman. A better way of explaining would be " Avoid food stuffs which are sweet and which stick to your teeth like toffees and pastries. Eat food items like fruits and raw vegetables which in addition to being healthy, also help in keeping your teeth clean.

EDUCATIONAL APPROACH

-Most effective means for achievement of changes in the health practices and lifestyles of the community. -Result obtained from this approach is slow but permanent and enduring -Sufficient time should be allowed for the individual to bring about the desired changes in his behavior

Projected aids

-Needs projection from a source on to the screen Films or cinemas Film stripes Slides Overhead projectors Transparencies Bioscopes Video cassettes Silent films

PANEL DISCUSSIONS

-Panel of 4 to 8 experts sit and discuss a topic in front of an audience -Headed by a chairman who opens the session, introduces the speakers and keeps the discussion going -Audience are allowed to ask questions -Chairman sums up the different views presented

Two way communication

-Participation from both the sender and the receiver. -Learning is active and democratic -It is more likely to influence behavior

USE OF HEALTH SERVICES

-People have to be inform about the various health services and preventive programmes available to them. -They also have to be educated on the proper use of these services. -They also be encourage to participate in the health programmes.

PREVENTION OF ACCIDENTS

-People have to taught about the basic safety rules and how to prevent common accidents which takes place in their home, in their work place or on the road -Health education programs to educate the students, parents and teachers about the use of mouth guards when playing contact sports

NUTRITION

-People should be taught about the nutrient value of food stuff and the effect of nutrients on health -It is to help people to choose optimum and balanced diets

DEMONSTRATIONS

-Procedure is carried out step-by-step in front of an audience -Method involves the audience in discussion and has a high motivational value -The audience can then carry out the procedure themselves with expert help

CONFERENCES OR SEMINARS

-Program range from half day to one week -Held on a regional, state or national level -They usually have a theme

Re-orienting health services

-Reorienting health services require a stronger attention to health research as well as to changes in professional educating and training -There must be a change of attitude and organization of health services, with the health sector moving increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services -Eg:-Dentists can be encouraged and rewarded for effective prevention and research activities

ROLE PLAYING/SOCIO DRAMA

-Size of the group should be 25 -The audience should take part -Situation is dramatized to make communication more effective -It is followed by a discussion on the problem -Puppet shows is a type of socio drama -Useful for children's health

Individual Approach (Disadvantages)

-Small number can benefit -Health education is given to only who come in contact with the dental surgeon or with public health personnel

COMBINATION OF AUDIO- VISUAL AIDS

-Sound and sight can be combined together -Televisions -Tape and slide combinations -Video cassette players and records -Motion pictures or cinemas -Multimedia computers -These also include traditional media-folk dance, folk songs, puppet shows, dramas

VARIOUS MASS MEDIA USED

-Television -Radio -News papers/press -Documentary films -Posters -Health exhibition -Health magazines -Health information booklets -Internet

SETTING AN EXAMPLE

-The health educator should follow what he preaches. -He should set an example to others to follow -Eg: A health educator who participate in a program highlighting the ill effects of tobacco should not be seen smoking since it sends a wrong signal and seriousness of the situation is lost

CULTURAL BARRIERS

Patterns of behavior, habits, beliefs, customs, attitudes, religion

REINFORCEMENT

-This is the principle that refers to the repetition needed in health education -It is not possible for the people to learn new things in a short period of time -So repetition is a good idea -This can be done at regular intervals and it helps people to understand new ideas or practice better -"booster dose in health education"

GOOD HUMAN RELATIONS

-This principle states that the health educator should have good personal qualities and should be able to maintain friendly relations with the people -The health educator should have a kind and sympathetic attitude towards the people and should always be helpful to them in clarifying doubts or repeating what is not understood

FAMILY HEALTH CARE

-To strengthen and improve the health of family as a unit rather than as an individual -Improving maternal oral health to improve the oral health of child should also be addressed

HUMAN BIOLOGY

-Training of human biology should start from the kindergarten itself -Children are taught about the different parts of the human body and their functions -They are also taught the importance of good health and methods to keep physically fit -Teaching also directed towards the need for exercise, adequate rest and sleep -Information about the adverse habits

Communication (process)

-essentially the transfer of ideas, messages or information from one person to another. In this process a cycle of communicating messages is formed between the sender and the receiver. -The sender is required to conceive the message he wishes to send, encode this message and then transmit. -The receiver then is require to receive this message, decode is and clarify his/her understanding of the messages.

Health education (introduction)

-is the process of imparting information about health in such a way that the recipient is motivated to use that information for the protection or advancement of his own, his family's or his community's health -an active learning process, which aims at favorably changing attitudes and influencing behavior w.r.t health

Projected aids (Advantages)

-real life situations can be enacted in films -Self explanatory -Creates a special interest among the audience to watch a film -Situational effects can be shown in a film

The five priority action areas for health promotion

1.Building healthy public policy 2.Creating supportive environments for health 3.Strengthening community action for health 4.Developing personal skills 5.Re-orienting health services

PRINCIPLES OF HEALTH EDUCATION

1.CREDIBILITY 2.INTEREST 3.PARTICIPATION 4.MOTIVATION 5.COMPREHENSION 6.REINFORCEMENT 7.LEARNING BY DOING 8.KNOWN TO UNKNOWN 9.SETTING AN EXAMPLE 10.GOOD HUMAN RELATIONS 11.FEEDBACK 12.COMMUNITY LEADERS 13.SOIL, SEED, SOWER

METHODS OF HEALTH EDUCATION

1.Individual approach 2.Group approach -chalk and talk -symposium -Group discussions -Panel discussions -Work shop -conferences or seminars -role playing/ socio drama -demonstrations 3.Mass approach

TYPES OF COMMUNICATION

1.One way and two way communication. 2. Verbal and non-verbal communication 3. Formal and informal communication

BARRIERS IN COMMUNICATION

1.Psychological barriers 2.physiological barriers 3.Environmental barriers 4.Cultural barriers

Receiver

Audience may be a single person or a group. Two types of audience are Controlled-It is held together by a common interest. It is a homogenous groups. Uncontrolled-It is a group which has gathered together because of curiosity.

FEEDBACK

For any program to be successful it is necessary to collect feedback to find out if any modifications are needed to make the program more effective

Formal and informal communication

Formal communication-follows lines of authority Informal communication- conversing with friends or colleagues

CONCLUSION

HEALTH EDUCATION HAVE THE POTENTIAL TO TACKLE THE UNDERLYING DETERMINANTS OF ORAL HEALTH AND THEREBY IMPROVE THE ORAL HEALTH OF ALL SECTIONS OF SOCIETY.IT HAS AN IMMEDIATE IMPACT ON BEHAVIOR.IT IS VITAL TO THE PRACTICE AND PREVENTION AND IS THE CHANNEL FOR REACHING THE PEOPLE AND ALERTING THEM TO HEALTH SERVICES AND RESOURCES.THE FOCUS OF HEALTH EDUCATION IS ON PEOPLE &THEIR ACTIONS THROUGH PLANNING AND TEAMWORK.ITS GOAL IS TO MAKE REALISTIC

Building healthy public policy

Health promotion put health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health

LEGAL OR REGULATORY APPROACH

Make use of the law to protect the health of the public Government makes laws and regulations Eg:-Epidemic diseases act -Pollution act -Food adulteration act -Environmental act

SOIL, SEED, SOWER

Soil is the community Seed is information Sower is the person giving the information

Stage of awareness

Stage in which individual has some general information about the new idea or practice, but does not know much about it's usefulness, limitations etc.

Stage of unawareness

Stage in which individual not aware of new idea or practice

Stage of interest

Stage in which individual showing more about the new idea or practice

Stage of trial

Stage in which the individual decides to put the new idea or method into practice. Additional information and guidance should be given at this stage

Stage of adoption

Stage in which the individual finally accepts the new idea or practice as beneficial to him and adopts it

Stage of evaluation

Stage in which the individual tries to find out he advantages and disadvantages of the new method. He evaluates whether the new practice will be beneficial to him and his family

EDUCATIONAL AIDS USED IN HEALTH EDUCATION

The aids used for transmitting health education are the main constituent of the armamentarium of health education process 1.Auditary aids 2.Visual aids 3.A combination of audio-visual aids

HYGIENE

The people are taught about the importance of hygiene and methods of maintaining hygiene

CONTROL OF COMMUNICABLE & NON COMMUNICABLE DISEASES

To provide elementary knowledge so that they can better understand common signs and symptoms of disease and prevention there by promoting health

Verbal and non verbal communication

Verbal- traditional way by word of mouth Non-verbal- bodily movements and facial expressions

INDIVIDUAL APPROACH

When an individual comes to the dental clinic or health centre because of illness, the opportunity should be used to educate him on matters of interest such as the cause and nature of his illness, its prevention, beneficial diets, oral hygiene etc. This approach can also be used by public health personnel, since they will be visiting homes and can interact with the individual and

MOTIVATING PEOPLE

concerned with clarifying/ changing or forming attitudes,beliefs,values or opinions. After health information is given it is necessary to motivate them alter their lifestyles so that it becomes favorable to promoting health and preventing disease.

GUIDING IN TO ACTION

concerned with development of skills and action. A person who has obtained health information might be motivated to change his behavior and lifestyle. However he might need professional help and guidance so as to bring about these changes and to sustain these altered lifestyles

INFORMING PEOPLE

people are informed about the different diseases, their etiology and how to prevent them.

Community hygiene

care of the surroundings ensuring proper garbage disposal, adequate sewage and drainage

COMMUNICATION

regarded as a two way process of exchanging or shaping ideas, feelings and information to bring about desired changes in human behavior.

Domestic hygiene

keeping the house and surroundings clean, proper ventilation, adequate light and fresh air, proper disposal of waste materials, avoidance of pests, insects etc.

Health communication

key strategy to inform the public about health concern and to maintain important health issues on the public agenda. The use of the mass and multi media and other technological innovations to disseminate useful health information to the public, increases awareness of specific aspects of individual and collective health as well as importance of health in development.

EDUCATIONAL APPROACH (components)

motivation, communication and decision-making

Environmental hygiene

this comprises two aspects-Domestic and Community

Personal hygiene

to promote good standards of personal cleanliness