210 FINAL

Rules of good health, 1922

A Full bath more than once a week Brush teeth at least once a day Sleep long hours with windows open Drink as much milk as possible, but no coffee or tea Eat some vegetables or fruit everyday Drink at least 4 glasses of water a day Play part of every day outdoors A bowel movement every morning

cultural competence

understanding values, principles, behaviors, and attitudes of populations

expectancies

values placed on the outcome

Rotary International

worldwide eradication of Polio, vaccinate kids, etc. Countries that still have Polio: Pakistan and Afghanistan

secondary sources of info

written by someone who *was not present* or did not participate as part of the study team ex: *journal review articles* *editorials* *non-eyewitness accounts*

primary sources of info

written by the person who *actually conducted the experiments* or observed the events ex: *refereed or peer-reviewed journal articles* (some now in electronic format and known as "open access" journals) *legislative records* *minutes of meeting*

Theory definition

"...a set of INTERRELATED CONCEPTS, DEFINITIONS, & PROPOSITIONS that presents a SYSTEMATIC VIEW of events or situations by specifying relations among variables in order to EXPLAIN OR PREDICT ... the events of the situations."

Theory vs. Practice

"To separate theory and praxis (or theoretical thinking from action) is an artifact. There is nothing more valuable, more enlightening, and more empowering that the marriage of the right type of question with the appropriate answer, to build understanding, to shape professional practice, and to sharpen our professional awareness. . . Theoretical thinking is intricately tied to practice." "The best theory is informed by practice; the best practice should be grounded in theory." *can't separate them from each other*

Responsibility III - Implement Health Education

*Actual presentation of the program* Understand priority population Comfortable with wide range of educational methods/techniques *Continue to monitor once up & running* Apply a number of sub-competencies Adhere to code of ethics

licensure

*Agency or government* grants permission *to individuals* to practice a given profession by certifying that those licensed have attained specific standards of competence

health education research (responsibility IV)

"a systematic investigation involving the analysis of collected information or data that is ultimately used to enhance health education knowledge or practice and answers one or more questions about health-related theory, behavior, or phenomenon"

social determinants of health

"conditions in the environment in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes." Economic stability Education Social and community context Health and health care Neighborhood and built environment

what is school health?

"involves all the strategies, activities, and services offered by, in or in association with schools that are designed to promote students' physical, emotional, and social development"

philodoxy

"the love of opinions" presents problems for health education specialists

diffusion of innovation theory

"the process by which an innovation is communicated through certain channels over time among members of a social system." There is an INNOVATION: a new idea, technique, behavior, program, or practice that is perceived as new The process of moving new ideas into action.

what is health?

"the state of complete mental, physical and social well being not merely the absence of disease or infirmity" -WHO "a functional state which makes possible the achievement of other goals and activities." "a dynamic state or condition that is multidimensional (i.e., physical, emotional, social, intellectual, spiritual, and occupational) a resource for living, and results from a person's interactions with and adaptation to the environment"

Hippocratic oath

"to teach them this art if they so desire without fee or written promise" "I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone. To please no one will I prescribe a deadly drug, nor give advice which may cause his death. Nor will I give a woman a pessary to procure abortion." "I will leave this operation to be performed by specialists in this art. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction, and especially from the pleasures of love with women or with men, be they free or slaves. All that may come to my knowledge in the exercise of my profession or outside of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and never reveal."

Precaution Adoption Process Model

***MENTAL STATES*** 1) Unaware of issue 2) Unengaged by issue - heard about it but don't care 3) Undecided about acting - weighing pros and cons 4) Decided to act 5) Decided not to act **can go either route with precaution adoption** 6) Acting 7) Maintenance - becomes part of regular routine *not good for diet and exercise - it's a habitual change*

Transtheoretical model

***TIME*** Precontemplation - not considering at all Contemplation - thinking about change; 6 months or less Preparation - decided to & planning how to do it; 30 days Action - engaging in behavior; 6 months or less Maintenance - Prevent Relapse; after 6 months Termination - Zero temptation to return to old behavior Processes of change = strategies to move subjects from one stage to the next

steps 1-4 PRECEDE

**ASSESSMENT** series of planned assessment to generate information that can be used to guide decisions about health program planning in a community Social assessment Epidemiological, behavioral and environmental assessment Educational and ecological assessment Administrative and policy assessment

steps 5-8 PROCEED

**IMPLEMENTATION AND EVALUATION** planned, strategic implementation of the program or actions to be conducted based on information from the assessments, including evaluation of measures from the assessment Implementation Process evaluation Impact evaluation Outcome evaluation

steps of Diffusion

*1) Innovation Development* - refers to the development of the innovation itself. *2) Dissemination* - process by which the innovation is communicated. *3) Adoption* - refers to the "uptake" of the innovation by the target population. *4) Implementation* - regular use of the innovation, focus on improving self-efficacy and skills of adopters. *5) Maintenance* - focus on sustainability, keeping adoption of the behavior.

History: 1990s

*1990 - The first examination was given by the National Commission for Health Education Credentialing, Inc. (The first CHES certification issues)* 1994 - Graduate Standards were adopted by the National Commission for Health Education Credentialing. 1995 - The Joint Committee on National Health Education Standards published the National Health Education Standards. 1996 - The U.S Department of Labor approved the classification "Health Educator." *1996 - A Competency-Based Framework for the Professional Development of Certified Health Education Specialists was published*

History: 2000s-present

*2002 - The National Health Educator Competencies Update Project (CUP) was undertaken* 2010 - Patient Protection and Affordable Care Act was signed into law. *2010 - Texas A&M University offered the eMS in Health Education* 2011 - MCHES Examination was given for the first time. 2012 - National Federation of Independent Business v. Sebelius was decided (The U.S. Supreme Court upheld the ACA). 2012 - SoPHE and AAHE joined forces...a new professional beginning for the discipline. 2013 - Health care reform bill (The Affordable Care Act) began taking effect.

advanced study in health education

*Continuing education* -A must for staying current -Being active in a professional association -Required for CHES & MCHES *Master's degree (M.A., M.Ed., M.P.H., M.S., M.S.P.H.)* -Required for some positions -May bring more money; open doors for other positions -1-2 years to complete -Many colleges & universities offer degrees but not all are accredited

When evaluating information from the Internet make certain to check:

*Currency* - the timeliness of the information *Relevance* - the importance of the information for your needs *Authority* - the source of the information *Accuracy* - the reliability, truthfulness and correctness of the content *Purpose* - the reason the information exists

Hippocrates

*Developed a theory of disease causation consistent with balance/imbalance theory* Ideal person requires daily *physical activity, study and philosophical discussion* -only rich upper class could afford this lifestyle His theory was taught in medical schools through the 1st quarter of the 20th century! made *distinction between "endemic" and "epidemic" diseases* Hippocratic Oath *First epidemiologist* (endemic and epidemic diseases) *Father of modern medicine*

why should people act ethically?

*Ethics provide a standard by which we live* -Brings meaning or purpose to the life of an individual -Ethical behavior leads to a healthier and more satisfying life *Ethics help guide our decision making and assist us in making better choices*

how the government promotes health *executive orders

*Executive orders* -Issued by the President -Designed to help officers and agencies in the executive branch manage operations in the federal government Ex. Council for National Prevention, Health Promotion, and Public Health Duties include *providing recommendations to the President and the Congress concerning the most pressing health issues* confronting the United States and changes in Federal policy to achieve national wellness, health promotion, and public health goals, including the reduction of tobacco use, sedentary behavior, and poor nutrition

Value of life

*First & most basic principle*; no life should be ended without strong justification

cognitive based philosophy

*Focuses on content and factual information (knowledge gain)* May be best viewed as a foundation on which to build with other philosophies. But, knowledge change DOES NOT EQUAL behavior change.

continuum theory

*Identify barriers* *Quantify severity of barriers* Put the person on the continuum ex: health belief model, theory of planned behavior

what is the job of school health

*Instructing school-age children about health & health-related behaviors* *Tremendous potential to impact students* in the past, many school health teachers held a dual certification in health and physical education with most of professional preparation in physical education goal is to help students adopt and maintain healthy behaviors in adulthood

Joseph Lister 19th century

*LISTERINE* pioneer of *antiseptic surgery* discovered a way to reduce infections in wounds, washing of hands/clothing and surgical instruments. Drastically reduced infections

Romans

*Medically, imitators of the Greeks* Engineers, builders, administrators Extensive and efficient *aqueduct system* - purity of water was important; Water boards established Underground sewers, public, and private baths *First to build hospitals* *Created a public medical service (town Physicians)* - transition from afforded by only the well-to-do Studied anatomy and the practice of surgery

Professional Ethical Issues of Health Education

*Obligations and availability of services* - equality of opportunity/making professional services available to all citizens *Obligations between professionals and clients* - professional is honest and fair; client keeps commitments to professional; client is truthful and does not request unethical acts from professional *Obligations to third parties* - sharing client info with family members, teachers, employers, legal authorities, etc. *Obligations between professionals and employers* - obligation to obey employer is stronger than obligation to client; acting only as authorized *Obligations to the profession* - conducting research, reforming the profession, maintaining respect for the profession

what should you consider when making ethical decisions?

*Place* - diff actions appropriate in diff environments *Time* - learn from history/past decisions *Identity* - who am I?/how does this relate to me? *Social relationships* - will affect them; not everyone will agree *The ideal* - always aim for most noble ideals *The concrete* - choices arise from concrete events *Seriousness* - have a serious attitude toward the situation

health care settings responsibilities

*Planning, implementing, & evaluating programs* & activities Education: *1-on-1 or group patient education* services Administration - *grant proposal writing, public relations, employee wellness activities, marketing* Coordination & collaboration of/for activities

Middle Ages

*Political & social unrest; MANY HEALTH ADVANCES LOST* -With collapse of the Roman Empire, there was much political and social unrest -Many public health problems resulted from overcrowding -Little emphasis on cleanliness or hygiene Dark ages - health problems...magic and religious Christian beliefs impacted health - belief that disease was caused by sin or disobeying God What knowledge remained from Greek & Roman period was in cloisters and churches Characterized by great epidemics - black plague, small pox, leprosy, TB, syphillus

certification

*Professional organization* grants recognition *to an individual* who, upon completion of a competency-based curriculum, can demonstrate a predetermined standard of performance

innovation characteristics that affect diffusion

*Relative Advantage* Is the innovation better than what was there before? *Compatibility* Does the innovation fit with the intended audience? *Complexity* Is the innovation easy to use? *Trialability* Can the innovation be tried before making a decision to adopt? *Observability* Are the results of the innovation visible and easily measurable?

Edwin Chadwick 19th century

*Report on an Inquiry into the Sanitary Conditions of the Laboring Population of Great Britain* *Led to the formation of the General Board of Health in England in 1848*

Responsibility VI - Serve as a Health Education Resource Person

*Retrieve health education information* to answer questions Skill needed to access resources Select or develop educational resources for dissemination Establishing *effective consultative relationships* with those seeking assistance *Dr. Fehr's favorite*

Age of Enlightenment

*Revolution, industrialization, growth of cities* Miasma theory *Scientific advancements* continued throughout this period James Lind Edward Jenner Health education/promotion had still not emerged as a profession, but.... Philosophers of the time *"promoted the worth of each human life and the importance of individual health for the well being of society"*

alternative settings

*Teaching in postsecondary institutions*, which requires a graduate degree in health education Combining health education and *journalism* allows a person to report or write on health issues and trends Many opportunities exist for practicing health education/promotion in a *foreign country*; however, a degree and knowledge of a foreign language is often needed Sales positions with *health textbook companies, pharmaceutical companies, and medical supply companies* are available Increasing need for health education specialists in *long-term care facilities* working with the aging population

predisposing factors

*attitudes, values, beliefs, knowledge* in community members involve those thought processes that motivate the targeted behaviors. step 3 of precede-proceed

CONCEPTS of Diffusion of Innovation theory

*communication channels* - The means of transmitting the new idea from one person to another *social system* - A group of individuals who together adopt the innovation *time* - How long it takes to adopt the innovation

essential skills in worksite setting

*conduct needs assessments*; *prepare & conduct prevention, fitness & screening programs*; coordinate coalitions & committees; plan & manage a budget; employ evaluation strategies

concepts of multicausation disease model (noncommunicable disease)

*genetics* *behavioral choices* *environmental conditions* - toxic agents, pollutants, chemicals, etc. *medical care* - quality and accessibility *social circumstances* - education, housing, employment, poverty, crime

communicable diseases

*infectious* illness caused by a specific biological agent that can be transmitted from an infected person, animal, or inanimate reservoir to a susceptible host

INTRApersonal theories

*knowledge, attitudes, skills, values* of an individual targets changing the individual through educational programs, mass media, support groups, organizational incentives, peer counseling

steps of chain of infection

*pathogen* prevention: pasteurization, chlorination, antibiotics, disinfectants *human reservoir* prevention: isolation, surveillance, quarantine, drug treatment *portal of exit* prevention: gowns, masks, condoms, hair nets, bug spray *transmission* prevention: isolation, hand washing, abstinence *portal of entry* prevention: masks, condoms, safety glasses, bug spray *establishment of disease in new host* prevention: vaccines, health education, abstinence

Edward Jenner

*small pox vaccination* didn't eradicate small pox until 200 years later

community (Levels of Influence - Socioecological approach)

*social networks and norms*, which exist as formal or informal among individuals, groups, and organizations

socio-ecological vs. population-based approaches (chapter 1)

*socio-ecological* = individual characteristics, social relationships, organizational influences, community characteristics, public policy *population-based* = policy development, policy advocacy, organizational change, community development, empowerment of individuals, economic supports

popular press publications

*written for the general public's consumption*; *may include primary or secondary sources*; hard to check credibility ex: *weekly summary-type magazines, monthly magazines, tabloids*

unethical conduct examples

-Failure to comply with laws -Exercising undue influence on the learner, subject, patient, or client for financial gain -Directly or indirectly giving or receiving fees or other considerations from 3rd a third party -Conduct that evidences moral unfitness to practice the profession -Making or filling a false report, or failing to file a report required by law -Failing to make copies of documents in the control of the health educator available to subject. -Revealing subject information without consent -Practicing beyond the scope of the law -Delegating responsibilities to unqualified persons -Advertising for patronage that is not in the public interest

critically reading a research article

-Were the goals/aims of study clearly defined? -Were the research questions/hypotheses clearly stated? -Was the description of the participants clear? -Was the design and the location of the study described clearly? -Were the data collection instruments described? -Were reliability and validity reported for the instruments? -Did the results directly address the research questions/hypotheses? -Were the conclusions reasonable in light of the research design and data analyses performed? -Were the findings extrapolated to a population that is similar to the population studied? -Were the study implications meaningful to the population you serve?

Code of Hammurabi

-rights and duties of the surgeon -contains laws pertaining to health practices and physicians, including first fee schedule "If a physician operate on a man for a severe wound, with a bronze lancet, and cause the man's death; or open an abscess (in the eye) of a man with a bronze lancet, and destroy the man's eye, they shall cut off his hands."

top 10 leading causes of death

1) *Heart disease* 2) *Cancer* 3) *Chronic lower respiratory diseases (CLRD)* 4) *Accidents* 5) Stroke 6) Alzheimer's disease 7) Diabetes 8) Influenza/pneumonia 9) Kidney disease 10) *Suicide*

determinants of health

1) *genetics* - sex, age, individual characteristics 2) *health behavior* - diet, physical activity, alcohol use 3) *social circumstances* - education, socioeconomic status, housing, crime 4) *environmental conditions* - safe water, where you live, crowding conditions 5) *health services* - access to quality health care, having vs. not having insurance

top 3 leading causes of death ages 10-24

1) Accidents 2) Suicide 3) Homicide

5 ways theory helps in planning, implementing & evaluating

1) indicates *why people aren't behaving in healthy ways* 2) *identifies information needed* before developing an intervention 3) *provides a conceptual framework* for selecting constructs to develop the intervention 4) gives insights into *how to best deliver the intervention* 5) identifies *measurements needed to evaluate* the intervention's impact

criteria for an ethical issue

1) must be "issues" - must be a controversy over the topic 2) must involve a question of right or wrong

9 leading PREVENTABLE causes of death

1) tobacco 2) diet and physical inactivity 3) alcohol 4) microbial agents 5) toxic agents 6) sexual behavior 7) firearms 8) motor vehicles 9) drug use

7 areas of responsibility for CHES

1. Assess, needs, assets and capacity 2. Plan 3. Implement 4. Evaluate/research 5. Administer and manage 6. Serve as a resource 7. Communicate and advocate

19th century (Late 1800s)

1842 Edwin Chadwick 1854 John Snow 1862 Louis Pasteur 1870-80s Robert Koch 1860-70s Joseph Lister

Marine Hospital Service Act

1798 hospitals and medical services for sailors owners of ships had to pay the tax collectors 20 cents per month for every seaman they employed; first prepaid medical insurance plan in the world Eventually became the U.S. Public Health Services (1912)

Shattuck Report

1850 *visualized how to improve the public's health through the initiation of state and local health departments* *addressed public health issues in Massachusetts* and recommendations for solving the problems (*36 out of 50 are accepted principles of PH*) recommendations included: keeping of vital statistics, environmental sanitation, control of food and drugs, routine physical exams, etc.

History: 1830-1930

1865 - Women's Christian Temperance Union successfully called for mandatory drug education. *1901 - Thomas D. Wood established a professional preparation program at Columbia University.* 1910 - The first White House Conference on the Health of Children was convened. 1911 - The Joint Committee (NEA/AMA) was established. *1918 - The American Child Hygiene Association was established. (Later became "Health"; then ASHA)* 1918 - Sally Lucas Jean named Health Education. 1930 - The National Institute for Health was established.

History: 1930-1960s

1930s - Development of social programs following the Great Depression = *Social Security Act of 1935* 1946 The World Health Organization defined health; *Hill-Burton Act* *1950 Society for Public Health Education (SOPHE) was formed* 1950 The Mid-Century Conference on Children and Youth was convened. 1953 The Department of Health, Education, and Welfare was established. 1954 The School Health Education Study was conducted. 1965 *Medicare and Medicaid - amendments to the Social Security Act*

History: 1970s

1971 President's Committee on Health Education was formed. 1974 *The Bureau of Health Education was formed at the CDC* *1974 - Lalonde Report (Canada)* 1975 - National Center for Health Education was established in San Francisco. 1976 - Association for the Advancement of Health Education was established in AAHPERD. (Became American Association for Health Education) 1978 - Office of Comprehensive School Health Education was formed in the U.S. Department of Education. 1978 - National Task Force on the Preparation and Practice of Health Educators was formed. *1978 - Workshop on Commonalities and Differences in the Preparation and Practice of Health Educators was held in Birmingham* *1979 - Promoting Health & Preventing Disease: Objectives for the Nation was published*

history of Role Delineation

1974, Helen P. Cleary, SOPHE President -found the profession in disarray 1978, Bethesda Conference on Commonalities & Differences Early 1980s: curriculum guide created pretested around the country; later turned into a curriculum framework (responsibilities, competencies, & sub-competencies) 1986, 2nd Bethesda Conference 1988, NCHEC formed

History: 1980s

1980 - Initial Role Delineation for Health Education was published. 1983 - AAHE and SOPHE began merger talks. 1985 - School Health Education Evaluation Study Final Report was published. 1988 - The National Adolescent Student Health Survey was published. 1989 - NCHEC was established.

A Competency-Based Framework for Health Education Specialists-2010

7 responsibilities 39 competencies 223 sub-competencies -162 entry-level sub-competencies -61 advanced-level sub-competencies (advanced sub-competencies are learned through practice)

how many CE hours for CHES

75 hours over a 5 year period

model

A mixture of ideas or concepts taken from any number of theories and used together Help people understand a specific problem in a particular setting or context Not always as specific as theory *do not attempt to explain, only to represent*

Specific Federal Agencies

Department of Health and Human Services -Oversees and runs MOST national health programs Department of Agriculture Department of Education Interagency Cooperation

primary prevention AKA primary health promotion

Identifying and strengthening protective ecological conditions that are conducive to health *Identifying and reducing various health risks*

examples of professional organizations

AAHE American Association for Health Education APHA American Public Health Association ACHA American College Health Association ASHA American School Health Association SoPHE Society for Public Health Education IUHE International Union for Health Education AAHB American Academy for Health Behavior ESG Eta Sigma Gamma

MCHES

Advanced certification awarded to health education specialists who meet the competencies established by the profession must be in the practice for 5 years before you can sit for the exam

advantages of worksite health

Affords excellent opportunities for prevention; Provides access to individuals who may not participate in community programs; Work with multiple & diverse groups; Most health education specialists enjoy their positions & report a high degree of job satisfaction; Pay is usually higher than in other settings; Benefits are usually good, but they vary considerably from employer to employer; Have access to fitness facilities for personal use

organizations represented on the National Task Force on the Preparation & Practice of Health Education

American College Health Association American Public Health Association American School Health Association Association for the Advancement of Health Education Conference of State and Territorial Directors of Public Health Education Society for Public Health Education Society of State Directors of Health, Physical Education and Recreation

reasons why there are so many old people

Americans living longer Couples having fewer children Baby boomers (By 2040, the population over 65 is expected to grow to equal 23% of the total population, an increase from 12.6% in 2010)

endemic

An illness that occurs regularly in a population

epidemic

An unexpectedly high rate of an illness in a population

why study history?

Appreciation through understanding of origins Allows us to see progress made & observe trends over time Identify struggles & obstacles faced by pioneers of the profession - and how we may or may not be similar today Allows us to learn from the past

service, fraternal, religious groups

Are often involved in health education/promotion related projects These may include drug education programs, wellness efforts, and a variety of other services Examples - Rotary International, Lions, Shriners, and American Legion

Quasi-governmental agencies

Are so named because they possess characteristics of both governmental health agencies and of nongovernmental agencies Obtain funding from a variety of sources Ex: American Red Cross & United Way

voluntary health agencies

Are some of the most visible health agencies Most voluntary health agencies have four primary purposes: *1. Fund research* *2. Provide education* *3. Provide service* *4. Advocate for beneficial policies, laws, and regulations* Created for specific diseases/specific organs/specific groups most money comes from *donations*

health-related quality of life (HRQOL)

Aspects of overall quality of life that have been shown to affect health - either physical and mental frequently used with chronic disease

topics on CHES exam

Assess Needs, Assets, and Capacity for Health Education/Promotion - 15% Plan Health Education/Promotion - 18% *Implement Health Education/Promotion - 25%* Conduct Evaluation and Research Related to Health Education/Promotion - 9% Administer and Manage Health Education/Promotion - 12% Serve as a Health Education/Promotion Resource Person - 9% Communicate, Promote, and Advocate for Health, Health Education/Promotion, and the Profession - 12%

honesty

At the heart of any moral relationship is communication; telling the truth

Evaluating the Accuracy of Non-Research-Based Sources

Authors qualifications? Degree? Scientific style of presentation? References included? Purpose of publication? Reputation of the publication? Referred or peer-reviewed? Information new?

life expectancy

Average # of years of life remaining to a person at a particular age

how the government promotes health *grants and contracts

Award of financial assistance from a federal agency (~$500 Billion/year) Carries out support or stimulation for specific topic areas NOT assistance or loans to individuals

Health education and promotion from a SNT perspective

Develop new social network linkages and training in social skills (Big Brothers-Big Sisters) Enhance networks through "natural" leaders (Natural Helpers) Enhance networks through community capacity building (Community Voices)

Responsibility II - Plan Health Education

Based upon needed assessment Recruit stakeholders to help plan *SMART plans* Develop *goals and objectives* Develop appropriate interventions *Rule of Sufficiency* - effective enough to accomplish the program objectives

Theory of Planned Behavior

Behavior is a function of: their attitude toward the behavior, their belief of what others think they should do, and their perception of level of ease or difficulty of the behavior in which they are considering action *Attitudes* toward behavior - Behavioral beliefs; Evaluations of behavioral outcomes *Subjective norms* - how do I think my friends would feel about me doing this; Normative beliefs; Motivation to comply *Perceived behavioral control* - perceived power *Behavioral intention* - leads to behavior (What do we plan to do)

The Person (Social Cognitive Theory)

Behavioral Capability Expectations Expectancies Locus of Control Self-Control Self-efficacy Emotional-coping response

Epidemics during Middle Ages

Black Death Leprosy, smallpox, diphtheria, measles, influenza, tuberculosis, and anthrax Concept of disease contagion became more universally accepted Syphilis - last major epidemic disease of this period

Hebrews

Book of Leviticus in the Bible first written hygienic code Personal/ community responsibilities -Cleanliness, protection from contagious diseases, isolation, disinfection, sanitation, hygiene

health-adjusted life expectancy (HALE)

Disability and life expectancy; # of years of healthy life expected on average in a given population

History: Public health evidence

Discovery of bathrooms and drains, and broad, paved, and drained roads in India; even found drain pipes in an excavated home (4,000 years ago) Smith Papyri (~1600 B.C.) Code of Hammurabi (2080 B.C.)

Professional Health Organizations

Common mission is to *promote the high standards of professional practice* for their respective profession The professional health organization: -Advocates for the profession -Provides publication of journals and newsletters -Provides opportunities for professional meetings -Provides membership perks -Is *funded by membership dues*

Lalonde Report

Canadian, 1974 importance of lifestyle and environmental factors on health

when assessing a social network's role, SNT considers:

Centrality vs. Marginality how involved is the person in the network? Reciprocity of relationships are relationships one-way or two-way? Complexity or intensity of relationships in the network do relationships exist between two people, or are they multiplexed? Homogeneity of diversity of people in the network are the people similar or different? Subgroups, cliques, and linkages are there cliques? do they interact with others or are they isolated? Communication patterns in the network how does information pass between members in the network?

CHES

Certification awarded to health educators who meet the competencies established by the profession

Renaissance

Characterized by gradual *REBIRTH of thinking* about the world and humankind in a more *naturalistic and holistic* fashion *Science reemerged* as legitimate field of inquiry, *numerous scientific advancements* Disease and plague still ravaged Europe, *medical care was rudimentary* (blood-letting still common practice) Royalty suffered from many health problems just as commoners did *Disposal of human waste and severe uncleanliness* were common problems Superstitions slowly replaced by systematic inquiry into cause and effect: -Gutenberg press = increase in learning and knowledge -Van Leeuwenhoek - microscope -Graunt - studied the Bills of Mortality *Health boards formed in Italy* -Wide jurisdiction eventually - including food, water, sewage, hospitals, beggars/prostitutes, burials, physicians, and drugs

last step of ethical decision making

Choose and act on choice monitor and evaluate results

public/community health

Community health education & public health education - same or different? *Similar skill set* Meet competencies of NCHEC *Compete for similar jobs* -Health of the community is closely linked to the health of the community members ex: voluntary health agencies and public health agencies

Implications for Practice Settings: Public/community

Community setting has greatest variety of options for the practice of health education While there are a variety of different community health options, community health education specialists are consistently involved in planning, implementing, and evaluating population level interventions

Coalition of National Health Education Organizations (CNHEO)

Comprised of AAHE, SOPHE, ACHA, ASHA, APHA - PHEHP & SHES, AAHB, DHPE, SSDHPER, & ESG Purpose: -Facilitate national level communication -Forum for the identification & discussion of profession issues -Formulate recommendations & take action on member interests -Serve as a communication & advisory resource on health education issues -Serve as a focus for the exploration & resolution of issues pertinent to health educators

public health in the US - 1800s

Continued overcrowding, poverty, and filth Industrial revolution continued to draw people to cities High rates of tuberculosis and malaria 1850 - Shattuck Report 1869 - First state board of health established in Massachusetts. (38 states had them by 1900) Establishment of the American Public Health Association - "national sanitary association"

activities of the Coalition of National Health Education Organizations (CNHEO)

Cosponsored two individual conferences to examine the status and future of the health education profession Creation of a unified "Code of Ethics for the Health Education Profession" Cosponsoring the annual national health education advocacy summit Support the Health Education Advocacy Web site

reasons to major in school health

Cost effective Still viable route to professional school with lots of field experience Shadowing opportunities in the school setting *Ability to add additional certificates* Universal skill set Cohort of friends Coaching opportunities Fun - limited "sit and get"

National Wellness Institute, Inc. (NWI)

Created to provide resources & services to health promotion & wellness professionals Memberships for both individuals & organizations Publications: -Four online publications -American Journal of Health Promotion National Wellness Conference at Stevens Point, WI

Responsibility IV - Conduct Evaluation and Research Related to Health Education

Critical to conduct accurate evaluation; prove worth Create a plan to assess the objectives *Collect, analyze, & interpret data* *Use results to modify/improve current or future programs* Research is vital to the profession Health education research

secondary prevention AKA secondary health promotion

Identifying, adopting, and reinforcing specific protective behaviors *Early detection and reduction of existing health problems* - to limit disability and prevent more serious pathogenesis

early majority (consumers of innovation)

Interested in innovation, but need external motivation Adopt just before the average Not the first but not the last

examples of behavior change theories

socio-ecological approach all theories except Precede-Proceed

1st step of making ethical decisions

Define the problem and identify ethical issues seek answers to relevant questions

browser

software that allows one to access information, e.g., Internet Explorer, google chrome

Ethics

Derives from the Latin ethos meaning "character" *the study of morality*

what do theories do?

Describe: They facilitate an understanding (a description) of a phenomena. Explain: They allow us to "make sense" (explain) of events observed. Predict: They allow us to predict (with varying degrees of accuracy) the future.

Cons of decision making philosophy

Difficult to use without a cognitive basis May be difficult to simulate real life situations

types of community theories

Diffusion of innovation theory Community readiness model

Miasma theory

Disease was formed in filth and that epidemics were caused by some type of poison that developed in the putrefaction process. Vapors caused disease when inhaled They thought that if you wore a lot of perfume, burned incense, etc. would stop you from breathing bad vapors

how the government promotes health *involvement of cabinet-level departments

Disseminate health information in a quick and timely manner -TV, radio, internet, etc. Department of Health and Human Services

social capital theory

Does not provide a theory of change Does have an impact on health Type of *network resources* -Bonding -Bridging -Linking *Trust and reciprocity* *Norms and expectations* Networks combine with norms/expectations to provide trust and reciprocity

Responsibility VII - Communicate and Advocate for Health and Health Education

Effective *oral and written communication skills*, as well as mass media use *Translate difficult scientific concepts* so that *constituents understand the information* necessary to improve and protect their health *Initiate and support legislation, rules, policies*, and procedures that will enhance health of a priority population *Advocate* for health education and promoting the profession

Greeks

Emphasized *disease prevention along with treatment* Focused on BALANCE (physical (athletics), mental (philosophy), spiritual (theology)) - ill health = imbalance Asclepius - god of medicine Hygeia - power to prevent disease Panacea - ability to treat disease Physician role began to take shape - from wanderer to municipal physician; no licensure...built on reputation Emergence of science Hippocrates Hippocratic oath

Freeing/functioning philosophy

Emphasizes concepts of freedom, individuality, lifelong learning Freedom to function in a way satisfying to themselves Practices may not always be conducive to health Pleasing yourself may not be conducive to your health

how the government promotes health *federal regulations

Enforceable laws authorized by major legislation Enacted by congress Examples: -Clean Air Act -Food and Drug Act -Civil Rights Act Laws behind these acts are developed in government agency offices (FDA, EPA, OSHA)

pros of CHES certification

Enhances your professional credibility Provides you with a personal and professional accomplishment Gets recognition from peers and employers Expands your professional opportunities

benefits of national certification (CHES)

Establishes a *national standard of practice* *Attests to an individual's knowledge and skills* Assists employers in identifying *qualified health education practitioners* Creates a *sense of pride* and accomplishment Promotes *continued professional development*

why use theory?

Explains behaviors Presents strategies to change behavior Many theories to fit program needs depending on the unit of change desired -Individual -Social groups -Communities -Institutions

Health Belief Model

Explains the likelihood of an individual to take action to prevent a disease or injury based upon: Perceived susceptibility - can this happen to me? / Person must feel susceptible Perceived severity - how bad Perceived THREAT - Must feel threatened to change your behavior Cue to action - something that gets you thinking about it Perceived benefits Perceived barriers Self-efficacy - confidence in ability to do it

Social Network Theory

Explains the web of social relationships that surround people *Key component = relationship between and among individuals and how those relationships influences beliefs and behaviors* Social Network Theory is often viewed as less theory...and more description.

disability-adjusted life years (DALYs)

Expresses burden of living with a disability; 1 DALY = 1 lost year of healthy life as a result of being in a state of poor health or disability

environment (elements of health field concept)

External to the body Little or no control over Geography, climate, economy, industry

health education specialists must be able to... (chapter 9)

Find information Evaluate the validity of the information source Disseminate the information accurately through appropriate channels Explain the meaning of the information in an understandable manner

innovators (consumers of innovation)

First to adopt Venturesome Independent Risky and daring

Code of Ethics for Health Education

First written in 1976 Developed by SOPHE in 1979 Final draft approved in 1999

eclectic philosophy

Focuses on adapting an approach that is appropriate for the setting (school, community, work site, medical)

professional ethics

Focuses on the *actions that are right and wrong in the workplace and are of public matter* guide individual behavior in the work setting

joining a professional organization

For most organizations - complete application and send along with dues *Special membership criteria for AAHB, ESG, DHPE, SSDHPER, CNHEO* Dues depend on various lengths of & categories for membership Can join at various levels -National -Regional -State or local organizations

health education/promotion profession timeline

From the late 19th century to the 1950s, public health efforts have focused upon the control of infectious diseases 1950s-present, the focus has been on chronic diseases and diseases related to lifestyles It was recognized by the mid 1970s that health promotion efforts have great potential for reducing morbidity, saving lives, and reducing costs

which ethnicity is growing at the fastest rate?

Hispanic is #1 Asian-Pacific Islander is #2

agent

the element (pathogen/chain of infection labels) that must be present for disease to spread

human biology (elements of health field concept)

Genetics Maturation/aging Interaction of body systems

The Organizations of Health Education

Governmental Agencies Quasi-Governmental Agencies Nongovernmental Agencies

governmental health agencies

Have authority for specific duties outlined by the governing body. *Primarily funded by tax dollars* Managed by government employees *International agencies* - World Health Organization *National agencies* - U.S. Department of Health and Human Services *State agencies* - State health department *Local agencies* - Local health department

intrapersonal level theories

Health Belief Model Theory of Planned Behavior Transtheoretical Model Precaution Adoption Process Model

how the government promotes health *Laws enacted by Congress

Health Care Reform Bill The Child Nutrition and WIC Reauthorization Act -allocates funding and guidelines for the free and reduced lunch programs in public schools nation-wide

lifestyle (elements of health field concept)

Health behaviors Risk behaviors

healthcare organization (elements of health field concept)

Health care system quantity, quality, resources, etc.

results of 1st Bethesda Conference

Health education is one profession, doesn't matter where you work Credentialing system was necessary Created the ***National Task Force on the Preparation & Practice of Health Education***

disadvantages of health care settings

Health education/promotion may have low status & low priority within setting Must continually justify the program's value Jobs are difficult to obtain Turf issues over educational responsibilities can develop Hours may be long & irregular Some physicians may be difficult to work with

philosophy of symmetry

Health has physical, emotional, spiritual, & social components; all of equal importance.

Pros of decision making philosophy

Helps develop a *systematic approach to making decisions* Helps develop problem solving skills May help avoid repetition of mistakes "Choices" are crucial to the "healthy lifestyle" Makes learner more active than some other approaches Can enhance relevance

why does someone need philosophy?

Helps form the basis for reality; how we see the world Is a key factor in choice of occupation, spouse, religion, & friends Helps to determine how we live, work, play, & generally approach life Formed through new experiences, learnings, or insights

Eta Sigma Gamma (ESG)

Honorary open to health education students & professionals who meet entry guidelines Special interest in pre-service health educators 112 chapters on campuses; founded at Ball State University Publications -The Health Educator -The Health Education Monograph Series -Newsletter "The Vision"

disadvantages of worksite health

Hours are long & irregular to cover employees on all shifts; Upward mobility may be a problem, few managerial positions in the field; Health promotion programs & fitness centers often seem to be low on a company's priority list thus can be cut; Some companies subcontract their health promotion & fitness programs to outside vendors with only part-time positions; Have strong pressure to be extremely fit & be healthy role models for other employees

tertiary prevention AKA tertiary health promotion

Improving the quality of life of individuals affected by health problems individual has already incurred disability, impairment, or dependency *Avoiding deterioration, reducing complications* from specific disorders, and *preventing relapse* into risky behavior

Implications for Practice Settings: Health care

Increasing receptivity to the fact that health education specialists can make a positive difference in the prevention and management of disease Preventive services by medical providers are severely lacking mainly due to the time needed to provide such services Patient education in the health care setting has moved from an innovation to a required service

CUP Competencies Update Project

Initial Role Delineation Project began nearly 30 years ago; profession has matured 1998, Competencies Update Project (CUP) began *Purpose: determine the degree to which the initial role of entry-level was still valid & to continue to development of advanced-level responsibilities* 2004, CUP completed, final CUP Report released in 2005 -Based on completed questions from 4,000+ health education specialists -Recommendations for change

Benefits of joining a professional organization

Interact & *network* with professional in the field Develop professional colleagues & a professional identity *Professional guidance* & mentoring Leadership development Opportunity to serve & participate in an organization & grow professionally Keep up to date & earn *continuing education* Make professional contacts Get connected to job banks Discounts on fees for registration & publications

early adopters (consumers of innovation)

Interested in innovation but do not want to be the first Respected by others in the social system Looked to for advice

community health

the health status of a defined group of people and the actions and conditions to promote, protect and preserve their health

advantages of public health education specialist

Job responsibilities are highly varied & changing *Strong emphasis on prevention* Usually high community profile Work with multiple groups of people High degree of self-satisfaction Positions typically offer good benefit packages Positions typically allow for flex time

advantages of health care settings

Job responsibilities are highly varied & changing Increased credibility due to the health care connection Usually a high community profile Work with multiple groups of people Wages & benefits are good High degree of self-satisfaction

laggards (consumers of innovation)

Last ones Traditional Suspicious of new innovations Must be certain they won't fail before adopting

Social Cognitive Theory

Learning is a reciprocal interaction between the individual's environment, cognitive process, and behavior Reinforcement contributes to learning Reinforcement = anything that makes it more likely I will engage in a behavior The Person The Environment Reciprocal Determinism

Early humans

Learning through observation, trial and error Eventually developed health related rules and taboos -Burying the dead -Defecation away from communal areas and water sources Knowledge passed between generations Disease and accidents attributed to magical spirits and gods Disease prevention = sacrifices, amulets, avoiding haunted areas

how do we know what theory to use?

Like the parable of the elephant, theory depends on your "view" Depends on: -Work situation -Participants -Target behaviors

disadvantages of school health job

Long hours at the job including weekends & evenings Relatively *low status in a school district* when compared with teachers of more traditional subjects *Pay is low* when compared with professionals in other fields Student discipline problems Summer "free time" may be consumed with summer employment &/or returning to college for additional required coursework Difficult *dealing with conservative school boards, parents, & community groups* when teaching controversial issues *Resources may be limited* to support the program

Deontological (ethical theories)

Looking at the act; the end does not justify the means Theories "that claim that certain actions are inherently right or wrong without regard to their consequences"

Teleology (ethical theories)

Looking at the consequences; the end does justify the means Evaluate the moral status of an act by the goodness or the consequences

Responsibility I - Assess Needs, Assets, and Capacity for Health Education

MAY BE MOST CRITICAL STEP *Needs assessment* - determines what health problems exist, what assets are available to address the problems, & the overall capacity of the community to address the health problems *Capacity* - "both individual and collective resources that can be brought to bear for health enhancement" *Assets* - skills, resources, agencies, groups, & individuals Collect data: *primary & secondary*

worksite health responsibilities

Many & varied Conducting classes - e.g., fitness, nutrition Conducting screenings & personal training sessions Administrative functions; maintaining records & equipment, writing newsletters, health fairs Marketing the programs

MCHES

Masters CHES Must have minimum of 5 years in field to sit for exam

worksite health job requirements

May need two degrees; one a generalist like in health education/promotion & a second in specialty area like exercise physiology, nutrition, nursing or athletic training May need certifications - e.g., CHES, MCHES, ACSM, CPR, smoking cessation

Cons of freeing/functioning philosophy

May not facilitate change until damage has been done Could encourage unhealthy behavior among those lacking self-discipline Takes time Effected by defense Mechanisms (Rationalization) Can it be done without infringing on the health/rights of others?

years of potential life lost (YPLL)

Measure of premature mortality ex: if someone dies at age 30... 75-30 = 45 YPLL

American Academy of Health Behavior (AAHB)

Members are health education researchers that meet guidelines for acceptance into ~The Academy~ Newest & smallest health professional association Publication -American Journal of Health Behavior

American School Health Association (ASHA)

Members include health educators, nurses, & others that are concerned with health issues related to school-aged children & youth; ~2,000 members ASHA has sections & councils Publications -Journal of School Health -Newsletter "Pulse"

American Public Health Association (APHA)

Members represent the major disciplines of public health Sub-divided into sections (health education has two) -Public Health Education & Health Promotion Section -School Health Education Section Publications -American Journal of Public Health -The Nation's Health State APHA Associations

American College Health Association (ACHA)

Membership composed of those concerned about the health issues in colleges/universities; institution (~900) & individual memberships (~2,400) ACHA has eight sections & 11 affiliate organizations Publications -Journal of American College Health -Newsletter Action

a CHES is an individual that has...

Met academic eligibility Passed a written examination Has an ongoing commitment to continuing education and professional development

Robert Koch 19th century

Microbiologist *discovered microorganisms for anthrax, tuberculosis, and cholera*

Black Death

Middle Ages The Black Death (bubonic plague) - 14th century 20-35 million estimated deaths *1/3 of the world population* Conflicting view of causation (and thereby prevention/treatment) -Became extremely pious, self-denial -Lost faith and disregarded legal, moral, and sexual restraints -Brotherhood of the Flagellants (re-enactment of Christ's scourging would redeem the wickedness of the world)

Societal Trends

Much change in social norms & practices since 1960, e.g., rights of various groups, family structure, ethical concerns, reliance on technology *Technology* - improved quality of life -ex: new delivery methods, tailored communication, GIS tracking (geographic information system) *Family structure will continue to change* - traditional family is less common; postmodern family more common *Political climate* - frustration with politics & politicians -health & politics linked; advocacy will become more important for health education specialists *Medical care establishment & the Affordable Care Act (ACC)* -ACC promotes wellness; many uninsured; increase in managed care; costs continue to rise; health education specialists can help

Non-governmental agencies

Operate free from governmental interference Funding sources: *Private donations* Membership fees Categorized into the following subgroups: voluntary, philanthropic, service, religious, and professional agencies

advantages of school health job

Opportunity to *work with young people during their developmental years* Potential to *prevent harmful health behaviors from forming* *Opportunity to impact all students* because health education is usually a *required course* *Graduate degree is not needed* for entry-level employment *Good job security* Nice vacation periods Benefits are good Multifaceted career ladder Good retirement programs

stage theory

Ordered sets of categories into which people can be classified People will have different barriers in different stages ex: transtheoretical model; precaution adoption process model

results of 2nd Bethesda Conference

Over next two years, National Task Force on the Preparation and Practice of Health Education worked with Professional Examination Service (PES) to develop an exam Formed NCHEC

disadvantages of public health education specialist

Pay may be low particularly in voluntary agencies Soft money positions may be terminated when grant funding is gone so job security can be a concern Relying heavily on volunteers can be frustrating Never seems to be enough money to run all the programs that need to be offered in the way they should be offered Positions often require irregular hours that may include evenings & weekends Bureaucracy in public health agencies

autonomy (individual freedom)

People must have the freedom to choose their own way of being ethical within the framework of the other principles

Egyptians

Personal sense of cleanliness Pharmaceutic preparations Sewage and drainage **considered to be healthiest people of their time**

History: Early Culture

Physicians and/or medicine men -- seen for health information (education about health), treatment, and cures. Roles often held by a priest Egyptians Hebrews

quality assurance

Planned and systematic activities necessary to *provide adequate confidence that the product or service will meet given requirements*

policy/environment (Levels of Influence - Socioecological approach)

Policies and regulations at local, state and federal level that regulate or support healthy actions and practices

criteria to sit for CHES

Possess a *bachelor's, master's or doctoral degree from an accredited institution* of higher education; AND an official transcript that clearly shows a *major in health education*, e.g. Health Education, *Community Health Education*, Public Health Education, *School Health Education*, etc. OR Have an official transcript that reflects *25 semester hours* (37 quarter hours) of course work with specific preparation *addressing the Seven Areas of Responsibility* and Competency for Health Educators

Decision making philosophy

Presents a systematic approach that *equips learners with pragmatic skills* Involves *problem-solving and coping* skills

National Health and Nutrition Examination Survey (NHANES)

collected data through direct physical examinations, clinical and laboratory testing mobile examination center

credentialing

Process whereby an *individual or a professional preparation program meets the specified standards established by the credentialing body*, and is thus recognized for having done so How health education/promotion professions demonstrate quality assurance National commission for health education credentialing (NCHEC) - CHES and MCHES

International Union for Health Promotion and Education (IUHPE)

Professionals committed to development of health education around the world Organized through six regional offices Publications -Promotion & Education (multilingual quarterly) -Health Education Research -Health Promotion International -Reviews of Health Promotion and Education Online

Pros of freeing/functioning philosophy

Promotes lifelong learning Protects individual rights Encourages self-directed and autonomous decision making Allows for recognition of antecedents of unhealthy behavior

ethical theories

Provide frameworks to evaluate whether human actions are acceptable types = deontological and teleology

philanthropic foundations

Provide important funding of programs and research on a variety of health issues Philanthropic - altruistic concern for human welfare and advancement *Do not raise money* *Finance long-term projects*

Examine your decisions... Do they: (ethics)

Provide the greatest good for the most people (good motives and good results)? Bring about justice (fair and impartially administered)? Result in a utilitarian outcome (practical enough that it could work in foreseeable circumstances)? Increase the trust among people? Promote integrity and decrease deceit in relationships? Dissolve barriers between people? Increase cooperative attitudes? Enhance self-respect? Not exploit others? Eliminate confusion and allow individuals to move toward respect?

Pros of cognitive based philosophy

Provides Information and the facts. Established knowledge base (awareness). Is easy to quantify.

why health education philosophy?

Provides a bridge between theory and practice Helps answer the "whys" of health education and promotion Generally considered a helping profession/value helping others

Cons of cognitive based philosophy

Provides information but no "strategy" for change Limits educators and learners to cognitive domain Does not address antecedents of unhealthy change May be difficult to internalize/personalize information Information only may lead to victim blaming

responsibilities of public/community health specialist

Public health programs target individuals, local communities, states, and the nation Fund-raising coalition building committee work public speaking grant writing

National College Health Assessment (NCHA)

collects health data about college students

Accreditation

Recognized *professional body evaluates a professional preparation program*

socio-ecological approach

Recognizes the importance of the larger social system on individual behavior Looks at interaction between and interdependence of 2 levels "Individuals influence and are influenced by their families, social networks, and organizations which they participate, the communities they're a part of, and the society in which they live"

personal ethics

Relate to making decisions about "right and wrong" Relate to what a person does, and how a person does it

Article 6 (Code of Ethics)

Responsibility in Professional Preparation Prep and training of health educators, getting a quality education

Article 5 (Code of Ethics)

Responsibility in Research and Evaluation We have to be ethical when conducting research

Article 4 (Code of Ethics)

Responsibility in the Delivery of Health Education Promote integrity, respect rights, dignity, and confidentiality of all people

Article 3 (Code of Ethics)

Responsibility to Employers Responsibility to the people we work for

Article 2 (Code of Ethics)

Responsibility to the Profession Responsible for professional behavior, reputation of profession, and promoting ethical conduct among coworkers

Article 1 (Code of Ethics)

Responsibility to the Public Responsibility to the people we're trying to help

which health path has the most credentialing options after graduating?

SCHOOL HEALTH!!!! CHES and teacher certification

Society for Public Health Education (SOPHE)

SOPHE is only professional organization devoted exclusively to public health education & health promotion ~4,000 members 24 SOPHE chapters covering 33 states Good working relationship with APHA Publications -Health Education & Behavior -Health Promotion Practice -Newsletter "News & Views"

public health in the US - 1700s

Similar to Europe - small pox, cholera, diphtheria; yaws, yellow fever, and malaria as well in the southern states (because of slave trade) Quarantine to control diseases Saw the development of health boards (no $, no staff, no enforcement) 1789 Wigglesworth 1798 - Marine Hospital Service Act

program accreditation

Since 2000, accreditation a major focus of the profession Accreditation defined... "a process by which a recognized body evaluates an entire program against predetermined criteria or standards" (Cleary, 1995) Programs in colleges & universities are accredited Many Accrediting/Approval bodies

The Environment (Social Cognitive Theory)

Situation Observational Learning Reinforcements

late majority (consumers of innovation)

Skeptical about innovation Adopt after the average member of society Adoption is an economic necessity not a choice

SMART plans

Smart Measurable Achievable Relevant Time-sensitive

limitations of Social Network Theory

Social Network Theory does not fully explain health behavior Social Network Theory is a labor intensive theory that requires extensive data collection

interpersonal level theories

Social cognitive theory Social network theory Social capital

what do interpersonal theories seek to explain? (8 total)

Social norms Social learning Social power Social integration Social networks Social support Social capital Interpersonal communication

planning models

Sound health promotion programs are organized around a well-thought-out and well-conceived model *Models serve as frames from which to build; structure & organization for the planning process* No perfect model PRECEDE-PROCEED is only one

community readiness model

Stage theory for communities The stages of change for communities are NOT the same as for individuals The stages of readiness in a community have to deal with group processes and group organization, characteristics that a not relevant to personal readiness

environment (communicable disease model)

all other factors that promote or inhibit disease transmission

National Health Education Standards

Students will... 1. *Comprehend concepts related to health promotion* & disease prevention to enhance health 2. *Analyze the influence of family, peers, culture, media, technology*, & other factors on health behaviors 3. Demonstrate the ability to *access valid health information & products & services* to enhance health 4. Demonstrate the ability to *use interpersonal communication skills to enhance health* & avoid or reduce health risks 5. Demonstrate the ability to *use decision making skills to enhance health* 6. Demonstrate the ability to *use goal-setting skills to enhance health* 7. Demonstrate the ability to *practice health-enhancing behaviors* & avoid or reduce health risks 8. Demonstrate the ability to *advocate for personal, family, & community health*

goodness (rightness)

Subdivided into two related principles *nonmaleficence* - First duty is to do no harm *beneficence (or benevolence)* - Doing good; actions that provide for the greater good of the community

SuDOC

Superintendent of Documents numbers DHHS (dept of health and human services); census data and other gov't documents has a letters and a colon : to differentiate

INTERpersonal theories

Targets relationships with family members, peers, co-workers, etc. that may influence health-related behaviors (social influences) "assume individuals exist within, and are influenced by, a social environment. The opinions, thoughts, behavior, advice, and support of people surrounding an individual influence his or her feelings and behavior, and the individual has a reciprocal effect on those people"

wellness philosophy

always a positive quality that enables a person to strive to reach an optimum state of health in all dimensions.

morbidity

The incidence or prevalence of a disease

mortality

The incidence or prevalence of death

Reciprocal Determinism (Social Cognitive Theory)

The continuing interaction among the characteristics of a person, the behavior of that person, and the environment with which the behavior is performed.

using theory in practice

Theories provide direction and organizes knowledge Theories can help in planning, implementing, and evaluating programs Programs based upon sound theory more likely to succeed

Responsibility V - Administer and Manage Health Education

There is much to *administer & coordinate* More a function of the experienced health education specialist Facilitate *cooperation among personnel*, both within & between programs *Knowledge of existing programs* is important to avoid overlap in services

Implications for Practice Settings: School

Use of a comprehensive approach to school health will best assure that the health needs of all children are met

measuring health/health status

Use statistics based on the traditional medical model of describing ILL health Paradigm shift to the socio-ecological model???

methodology

includes research design participants of study instrumentation administrative procedures

US public health achievements - 1900s list of 10 things

Vaccination Motor-Vehicle Safety Safer Workplaces Control of Infectious Diseases Decline in deaths from Coronary Heart Disease and Stroke Safer and Healthier Foods Healthier Mothers and Babies Family Planning Fluoridation of Drinking Water Recognition of Tobacco use as a Health Hazard

health care settings

Variety of settings (e.g., hospitals, medical clinics, home health agencies, HMOs, PPOs) *HMOs have been most receptive to hiring* Third party reimbursement an issue Optimistic about future employment opportunities

Uniform Resource Locators (URL)

Web addresses; includes hypertext transfer protocol (http://), location (e.g., www.cdc.gov), & file name (e.g., mmwr)

Implications for Practice Settings: Worksite

Worksites have introduced an array of programs for employees and their families - many have incorporated health education/ promotion programs An awareness of changing demographic patterns and a concern that health care costs can be controlled through health promotion are creating increasing numbers of opportunities for health education specialists

Healthy People 2020

Written using MEASURABLE objectives Guides the nation's health policies and efforts Identified four primary MODIFIABLE health risk behaviors: 1) Lack of physical activity 2) Poor nutrition 3) Tobacco use 4) Excessive alcohol consumption

Coordinated School Health Program

a district-wide approach that coordinates and integrates the following to best impact the health of the students, faculty, staff, administration, and community as a whole: Food services Nursing services School counseling and psychology Health instruction Physical education School environment Community involvement Faculty/staff wellness

the health field concept

a framework designed because the health field encompasses far more than the "healthcare system" 4 elements: human biology environment lifestyle healthcare organization

rate

a measure of some event, disease, or condition in relation to a unit of population, along with some specification of time

emotional-coping response

ability to deal with the sources of anxiety that surround a behavior

social power

ability to influence others or resist activities of others ex: Regina George

Panacea

ability to treat disease

participation

active involvement of the priority population in helping identify, plan, and implement programs to address the health problems they face ensures ownership, minimizes ethical issues

health education specialist: definition

an individual who has met, at a minimum, *baccalaureate-level required health education academic preparation* qualifications, who *serves in a variety of settings*, and is *able to use appropriate educational strategies* and methods to facilitate the development of policies, procedures, interventions, and systems conducive to the health of individuals, groups, and communities

pandemic

an outbreak over a wide geographical area, such as a continent

home page

analogous to a combination of a cover & table of contents of a book

health education

any combination of *planned learning experiences* using evidence based practices and/or sound theories that provide the *opportunity to acquire knowledge, attitude, and skills needed to adopt and maintain healthy behaviors*

health promotion

any planned combination of *educational, political, environmental, regulatory, or organizational mechanisms* that support actions and conditions of living conductive to the health of individuals, groups and communities

host

any susceptible organism that can be invaded (plants, animals, humans)

Medicare

assists in payment of medical bills for ELDERLY

Medicaid

assists in payment of medical bills for POOR

essential skills in health care setting

aware of technological innovations to reach patients; provide training in health education to health care team; familiar with clinical disease processes; advocate for universal health care; prepare & deliver lessons; coordinate interdisciplinary teams; serve as a liaison; working knowledge of epidemiology & statistics

expectations

beliefs about the likely outcome

Precede-proceed

best known and often used Follows a logical sequence: -Identify a desired outcome -Determine what causes it -Design an intervention to address the desired outcome -Evaluate the outcomes from the intervention

Medline

biomedical medicine database

abstract

brief description of the study communicates essential information

linking

bringing together two social strata/hierarchy Least strong; most likely will dissolve after project SCap theory

bonding

brings together people who already knew each other SCap theory

reliability

can you get the same results repeatedly

advocacy

changing or swaying public opinion Health advocacy = change for health

Social Security

check given to old people to spend on whatever they want

worksite health promotion

combination of educational, organizational, and environmental activities designed to improve the health and safety of employees and their families Programs vary greatly from site to site Programs at 80% of worksites (>50 employees); almost all large employers (>750 employees)

professional socialization

coming to an understanding of what behaviors are appropriate in a professional role

interpersonal communication

communication between one person to another

American Legion

community Rec programs

National Health Care Surveys (NHCS)

comprised of six different surveys that are designed to answer key questions about health care providers - a seventh survey to be added

social networking

connecting individuals or organizations that are connected by one or more specific types of interdependency

Dr. Wigglesworth

created the first life expectancy table in 1789, life expectancy at birth was 28.15 years 2006 life expectancy = 77.7 years highest ever in US

social norms

culture, etc. "what are perceived to be true and acceptable"

primary data

data gathered by a health education specialist

examples of secondary prevention

detecting cancer early to prevent complications any examinations and screenings monitoring hypertension

2nd Bethesda Conference purpose

determine if credentialing system should be pursued

Early 1800s

did not see many health advancements

Praxis (Aristotle definition)

doing; "experience that comes from the encounter..."

why should people use ethics in health education?

ethical behavior... makes programs more effective; cements health educators standing in the community; allows educators to exercise moral leadership in the community; ensures we are in good standing legally and professionally

voluntary health agencies (public health setting)

ex: ACS, AHA, ALA Hired to plan, implement, and evaluate the education component of the agency's programs

public health agencies (public health setting)

ex: LHDs, state health dept, federal agencies Administrative, coordinating volunteers, budgeting, fund-raising, program planning, and serving as liaisons to other agencies and groups, as well as direct program delivery

unmodifiable health risks

exposure to environmental pollutants family history of cancer, diabetes, heart disease, etc. abnormal pap smear result serious loss or misfortune in past year witnessing or involvement in violent act

technology (asset needed by health education specialist)

familiar & comfortable with computers & other technology uses: connecting people with similar health interests, linking people who have a common cause/goal, sending information about health programs Social networking an important part

Promoting Health & Preventing Disease: Objectives for the Nation

federal document containing 226 US health objectives divided into 3 areas: preventative services, health protection, and health promotion provided framework for public health in the 1980s in 1990, Healthy People 2000 published; then Healthy People 2010

introduction

includes research questions/hypotheses literature review explains the need/significance of the study

community readiness model steps

first 4 steps: *1) No awareness* problem not recognized by community leaders goal - raise awareness of issue *2) Denial* little or no recognition of problem; feeling that nothing can be done goal - raise awareness that the problem exists *3) Vague awareness* some people feel there is a problem, but there is no leadership to do something about it goal - raise awareness that the community can do something *4) Preplanning* clear recognition of a problem; there are leaders but no focused or detailed planning goal - raise awareness with the concrete ideas to combat condition

Bethesda Conference on Commonalities and Differences (first) purpose

focused on commonalities/differences in *settings and preparation*

Shriners

fraternal group have 22 hospitals nationwide; provide service to children for free primarily care for kids with *burns*, orthopedics *repair of cleft palates*

examples of primary prevention

getting immunizations ensuring the supply of safe drinking water applying dental sealants to prevent tooth decay guarding against accidents.

ERIC

gives info and journal articles pertaining to *education*

Asclepius

god of medicine

HESPA

health education specialist practice analysist Basically CUP 2.0 Updated questions Most up to date information on what health education specialists do

global health

health problems, issues, and concerns that *transcend national boundaries* and are beyond the control of individual nations, and are best addressed by cooperative actions and solutions

when was first CHES exam

held in 1990

social support

help obtained through social relationships and interpersonal exchanges

search engine

identifies Web sites that includes the key words used ex: Google, Yahoo, Bing, Ask, AOL Search, Googlescholar

noncommunicable diseases

illness that cannot be transmitted from an infected host to a susceptible host

role modeling

important or not? it is debated; some people suffer from diseases that cause obesity, puts too much pressure on health education specialists

enabling factors

include *resources and skills* needed for behavior change to occur or barriers that may prevent it from happening—or both step 3 of precede-proceed

community theories

includes three categories from the socio-ecological approach: organizational, community and public policy *Organizational* factors include the *rules, regulations, and policies of an organization that can impact health* behavior *Community* factors include *social norms* *Policy* includes *legislation that can impact health* behavior

individual (Levels of Influence - Socioecological approach)

individual characteristics that influence behavior knowledge, attitudes, beliefs, values, personality traits

tertiary sources of info

information that has been *distilled & collected from primary & secondary sources*; includes facts ex: *handbooks, pamphlets, fact books, dictionaries*

risk factors

inherited, environmental, and behavioral influences which are thought to increase the likelihood of physical or mental problems

internet

integrated network of computers

world wide web

interactive information delivery service

interpersonal (Levels of Influence - Socioecological approach)

interpersonal processes and primary groups, including *family, friends, and peers* that provide social identity, support, and role definition

discussion

interpret conclusions & meanings comment on implications

justice (fairness)

just in distributing goodness & badness; subdivided into two area *procedural justice* - fair procedures followed *distributive justice* - allocation of resources

construct

key concepts of a specific theory; the concept has been developed, created, or adopted for use

Theoria (Aristotle definition)

knowing; "the experience of events that are constant, universal and eternal."

behavioral capability

knowledge and skills necessary to perform a behavior SCT

Robert Wood Johnson Foundation

largest philanthropic organization focused solely on health; 400 million dollars every year

observational learning

learning by watching others

social learning

learning that occurs in a social context

Lions Club

lions "quest for vision" preserve sight; take donations of old prescription glasses

government documents

materials printed by the U.S. Government Printing Office (GPO) organized using Superintendent of Documents (*SuDOC*) numbers variety of topics

validity

measures what it's supposed to measure

multitasking

skill of coordinating & completing multiple projects at the same time

PsychInfo

mental health and behavioral health studies

Hogg Foundation

mental health; from Texas

Van Leeuwenhoek

microscope proved there were life forms too small for human eye to see (not yet associated with disease)

multicausation disease model

model used to describe the *causes of noncommunicable diseases* -ex: heart disease, cancer they manifest in people over a period of time and are not caused by a single factor but combined factors

communicable disease model

model used to describe the spread of communicable disease includes 3 elements that are the minimal requirements for presence and spread of an infection: 1) agent 2) host 3) environment

chain of infection

model used to explain the spread of a communicable disease from one host to another individuals can break the chain & reduce the risk at any point; *spread of disease can be stopped* -not exposing yourself to the pathogen in the first place

soft money

money from grants

The Youth Risk Behavior Surveillance Survey (YRBSS)

monitors six categories of priority health-risk behaviors among youth and young adults 1) tobacco use 2) unhealthy dietary behaviors 3) physical inactivity 4) alcohol and drug use 5) sexual behaviors (HIV and STIs) 6) unintentional injuries

electronic databases

most indexes & abstracts now computerized allows for faster searches & ability to combine concepts to focus the search ex: ERIC, Medline, CINAHL, & PsychInfo

responsibilities of school health education specialist

must be well trained and prepared to deliver a comprehensive, standards-based curriculum School health education specialists' leadership role in *advocating for and development of school health policies* Curriculum development, active professional involvement, and advocacy

death rate

number of deaths per 100,000 population AKA mortality or fatality rate

CINAHL

nursing, allied health, health education, health administrations, health services

Smith Papyri

oldest written documents related to health care *details surgical procedures*

Hill Burton Act

passed to improve distribution and quality of hospitals resulted in too many hospitals being built; overlapping of services

informed consent

people should be given sufficient information from which to make informed choices about whether or not they want a certain medical procedure; or to participate in a research project or health education program *freedom to choose after being well informed on the consequences of participation*

bridging

people who didn't know each other How to make 2 people who don't know each other: build a bridge SCap theory

self-efficacy

people's confidence in their ability to perform a task

locus of control

perception of the center of control over reinforcement internal = you have control of reinforcements external = reinforcements controlled by external factors

social networks

person-centered webs of social relationships

nontraditional health education settings

pharmacy sales fitness equipment sales sale of health-related textbooks life and health insurance sales journalism TV/radio

ethical questions are answered through...?

philosophical thought, using reason, logic, & argument

Hygeia

power to prevent disease

social media

powerful channel to reach target audiences with strategic, effective, and user-centric health interventions

secondary data

preexisting information

concept

primary elements of theories

Gutenberg press

printing press with moveable type allowed health writings to be published and distributed; increase in learning and knowledge

Louis Pasteur 19th century

proposed *Germ Theory of disease* Incredible acceleration in the advancement of bacteriology; pasteurization of milk; *scientific approach to immunizations*

indexes and abstracts

provide link to articles from many refereed/ peer-reviewed journals, books, & research reports a few available in hard copy, most now online or electronic formats ex: Index Medicus

examples of tertiary prevention

providing rehabilitation giving careful attention to foot care to reduce amputation due to diabetes

journals

publish primary research articles & position papers many health related journals

crude rate

rate expressed for a total population

adjusted rate

rate expressed for a total population but is statistically adjusted for a certain characteristic, such as age

specific rate

rate for a particular population subgroup; such as for a particular disease

essential skills: school setting

read & interpret research findings; create scope & sequence; *prepare & deliver lessons*; evaluate lesson; assess health needs; *assure health & counseling services are provided*; participate in organizations;

results

research findings

reinforcement

responses to behaviors that increase chances of recurrence

reinforcing factors

rewards or encouraging feedback (positive or negative) that community members receive from other people step 3 of precede-proceed

James Lind

royal Navy surgeon discovered sailors could prevent *scurvy* if they drank lime juice

organizational (Levels of Influence - Socioecological approach)

rules, regulations, or policies which may constrain or promote recommended behaviors

settings for health education/promotion

schools public/community health agencies business/industry hospitals/clinics

essential skills in public/community setting

seek information; *assess communities*; coalition building; marketing techniques; flexibility; learn another language; *advocate*; work in a multidisciplinary environment; evaluation strategies that are outcomes-based; *working knowledge of epidemiology & statistics*

responsibilities

specify the *overall scope of practice*

philosophy

statement summarizing the attitudes, principles, beliefs, and values held by an individual or group "the love of wisdom" "Philosophy can be defined as a state of mind based on your values and beliefs. It is a synthesis of all learning that makes you who you are and what you believe."

social integration

structure and quality of our relationships

John Snow 19th century

studied epidemiological data to determine the source of a *cholera* epidemic in London *Broad Street pump handle removal*

Graunt

studied the *Bills of Mortality* - weekly publication in London used statistics and epidemiological concepts to study death rates among different populations *Helped further epidemiology*

research ethics

subset of professional ethics "Comprises principles and standards that, along with underlying values, guide appropriate conduct relevant to research decisions." Voluntary participation is the foundation of research ethics

Behavioral Risk Factor Surveillance System (BRFSS)

telephone survey of randomly selected adults about risk factors, preventive health practices, access to preventive services and health insurance

National Health Interview Survey

telephone survey that asked about health and health behaviors

hypertext

text that can searched, edited, stored, and connected to other documents

public health

the *science and art of protecting and improving the health of communities* through education, promotion of healthy lifestyles, and research for disease and injury prevention

health literacy

the ability to obtain and understand health related information Skill needed among all settings

situation

the current environment / what's happening around you

health disparity

the difference in health between populations often caused by two health inequities: *lack of access to care & lack of quality care*

population health

the health status of people who are *not organized and have no identity as a group* or locality and the actions and conditions to promote, protect, and preserve their health

epidemiological data

the information gathered when measuring health gathered at local, state, and national levels to: -assist with the prevention of disease outbreaks or control of those in progress -plan and assess health education/promotion programs

Holistic natured philosophy

the mind and body distinction disappears, yielding a whole unified being

variable

the operational form (practical use) of a construct quantifiable measurement of a construct

prevention

the planning for and the measures taken to forestall the onset of disease or other health problem before it occurs

disease prevention

the process of *reducing risks and alleviating disease* to *promote, preserve, and restore health* and minimize suffering and distress

social capital

the relationships and structures within a community, such as civic participation, networks, norms of reciprocity, and trust, that promote cooperation of mutual benefit It is a collective asset and feature of communities *Individuals can contribute to it and use it, but they cannot own it*

epidemiology

the study of the distribution and determinants of diseases and injuries in human populations

competencies

three to seven under each responsibility & *reflect ability to understand, know, etc.*

sub-competencies

three to twelve under each competency & *reflect specific skills*

modifiable health risks

tobacco use alcohol use blood pressure drug abuse hours of sleep life satisfaction level miles driven physical activity level seat belt use strength of social ties