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E Volution: Health Education In The Information Age

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Title: E Volution: Health Education In The Information Age


1
E Volution Health Education In The Information
Age
  • Robert S. Gold
  • Nancy L. Atkinson

2
  • As for the future,
  • your task is not to foresee,
  • but to enable it
  • www.phi.umd.edu

- Antoine de Saint-Exupery, The Wisdom of the
Sands
3
Before we start?
4
The Digital Divide?
5
Or Does It Look Like This?
ACCESS
LITERACY
LANGUAGE
DIVERSITY
QUALITY
JUDGEMENT
6
Purpose
  • What role do divides such as access and
    literacy play in the future of health education?
  • What are the implications of the digital
    e-volution for health and health education?
  • What are the challenges and opportunities for
    health education?
  • What are the opportunities?

7
ACCESS
  • Healthy People 2010 Objective 11-1 Increase the
    proportion of households with access to the
    Internet at home.
  • Target 80 percent.
  • Baseline 26 percent of households had access to
    the Internet at home in 1998.
  • Data source Computer and Internet Use Supplement
    to the Current Population Survey, U.S. Department
    of Commerce, Bureau of the Census.
  • National Educational Technology Goal 1 All
    students and teachers will have access to
    information technology in their classrooms,
    schools, communities and homes.

8
People with disabilities
9
LITERACY
  • Healthy People 2010 Objective 11-2
    (Developmental) Improve the health literacy of
    persons with inadequate or marginal literacy
    skills.
  • Potential data source National Adult Literacy
    Survey, 2002, U.S. Department of Education.
  • National Education Technology Goal 3 All
    children will have technology and information
    literacy skills

10
World Health Organization (WHO)
  • has recently defined health literacy more
    broadly, as follows
  • 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.
  • Health literacy means more than being able to
    read pamphlets and successfully make
    appointments.
  • By improving peoples access to health
    information and their capacity to use it
    effectively, health literacy is critical to
    empowerment. (WHO, 1998)

11
Health literacy . . .
  • This definition significantly broadens the scope
    of the content of health education, indicates
    that health literacy may have both personal and
    social benefits, and has profound implications
    for education methods.

12
One direction . . .
Or two?
13
How do you know when youve made it in todays
world?
14
  • If we can decode this

Why cant we decode this?
15
  • If we can figure out how to read this

Why cant we figure out how to read this?
16
  • If we can land here

Why cant we land here?
17
  • If we can build this

Why cant we build this?
18
  • If we know how to tailor messages

Why cant we figure out how to tailor
interventions?
19
  • If this is a cultural phenomenon

Why cant we figure out how to effectively apply
this kind of technology for health education?
20
  • If we have so many best practices
  • Why cant we figure out how to get health
    educators to use them effectively?

21
So here we are!
22
Core Technologies
  • EDI
  • Advanced satellites
  • Digital imaging
  • Simulations
  • Fuzzy logic
  • Superconductors
  • Fiber optics
  • Digital electronics
  • Optical data storage
  • Advanced video displays
  • Advanced computers
  • Distributed computing
  • Expert systems
  • Object oriented programming
  • The Web
  • Wireless applications
  • Handheld technologies
  • Biometrics

23
Appropriate technology can revolutionize
  • The delivery system of products and services
  • The way we communicate
  • The way we use and view television
  • The way we individualize and personalize
    education
  • The way we internalize, understand, and use
    massive amounts of data

24
Is This Vision Possible?
  • Visit The Neighborhood

25
Vision Statement
  • Equitable access to information technology
  • Ability to use information technology effectively
  • Quality health promotion interventions and
    information for all audiences
  • Ability to evaluate the quality of information
    delivered through new media

26
Vision Effective Use
  • Just supplying hardware and software is
    insufficient
  • Need to provide training and technical assistance
    on computer and Internet use
  • Need to provide support staff for computer
    maintenance and trouble shooting
  • Need to prepare gate keepers (e.g., teachers) to
    use technology with their constituents / end
    users (e.g., students)

27
Vision Quality Information Interventions
  • How do we maintain and improve on the efficiency
    of current public health interventions without
    dramatically increasing cost?
  • How do we contribute to the reduction in the
    disparity in morbidity and mortality for
    underserved populations?
  • How do we take appropriate advantage of advanced
    communications technologies to accomplish the
    first two?

28
  • The dominant training and public health
    educational media strategies today, and
    electronic media are insufficient to accommodate
    the full potential of todays and tomorrows
    needs.
  • More effective educational and communication
    tools are necessary.

29
If we are to . . .
  • motivate ever larger numbers to achieve their
    potential
  • deliver and track our efforts to remote and
    diverse populations
  • build societal databases that allow us to monitor
    the multiplicity of factors that determine the
    capacity and productivity of individuals,
    families, communities, and nations

30
Given the context of
  • A favorable atmosphere for building on technology
    infrastructure
  • Growing recognition of the importance of
    alternative technology based solutions to human
    problems, needs and interests and,
  • The philosophical guideposts provided by public
    healths traditions and vision

31
Then
  • . . . we must establish and act on a vision of a
    communications technology research and
    development paradigm that propels public health
    into its future of choice.
  • We must invest in a complex, diverse, well
    organized technology research and development
    infrastructure that will ensure that our vision
    is realized.

32
  • . . . it is an opportune time to examine ways to
    apply communications technologies to catalyze,
    instigate, guide, support, and monitor our
    progress. Yet, at the same time, we must
    recognize the importance of putting the tools
    and capacity in the hands of communities rather
    than limit them to governments and/or
    professionals

33
Imagine . . .
  • an array of strategies and tools that facilitate
    the active and systematic engagement of
    communities in defining and dealing equitably and
    intersectorally with their real issues and
    concerns.
  • Not only will we do good work
  • we will also do good.

34
Heres where we are today
  • e-networks
  • Exquisite illustrations of effective community
    building
  • Second and third generation tailoring
    technologies
  • Fully developed computer and web-based education
    and training courses and programs
  • Real-time data collection and analyses for
    assessments, survey and other research
  • Web-based data access, data-mining
  • Early, and some well developed decision-support
    systems
  • Interesting and useful simulations
  • Real time interaction with and without video

35
Where do we need to look?
  • To more highly refined applications for
    individuals
  • To an understanding and application of group
    applications
  • To an understanding and application of
    system-level applications

36
Heres where were going
  • More of the same, only highly refined
  • e-meeting technologies
  • Smart card technologies
  • Knowledge engineering
  • Understanding new types of data (e.g., video,
    audio)
  • Tacit knowledge
  • Knowledge management
  • High end decision-support and expert systems
  • Simulations
  • Neural networks
  • Real world systems

37
  • As for the future,
  • your task is not to foresee,
  • but to enable it
  • www.phi.umd.edu

- Antoine de Saint-Exupery, The Wisdom of the
Sands
38
The Internet
39
Digital inclusion
40
People online (in millions)
41
Population characteristics
42
Extent of the problem
  • A recent study of health literacy among Medicare
    enrollees in a managed care organization
    (Gazmararian, JA. JAMA, Feb 10, 1999) found that
    low health literacy was far more widespread than
    expected.
  • Overall 33.9 of English-speaking respondents had
    inadequate or marginal health literacy
  • 53.9 of Spanish-speaking respondents had low
    health literacy and,
  • Researchers found that health literacy declined
    dramatically with age, even after researchers
    made adjustments for years of school completed
    and cognitive impairment.

43
  • A 1995 study (Williams, MV. JAMA, December 6,
    1995), found
  • that 33 of patients at two public hospitals did
    not understand instructions for a common
    radiographic procedure written at the 4th grade
    level
  • from 24.3 to 58.2 of patients did not
    understand directions to take medication on an
    empty stomach
  • 20 of patients answered questions incorrectly
    regarding information on an appointment slip, and
  • 40.7 to 74.5 of patients surveyed did not
    understand the standard informed consent
    document.
  • The inability to understand informed consent
    documents is especially troubling because of the
    implied legal and ethical implications.

44
  • The estimated additional health care expenditures
    due to low health literacy skills are about 73
    billion in 1998 health care dollars. This
    includes an estimated 30 billion for the
    population that is functionally illiterate plus
    43 billion for the population that is marginally
    literate.

45
Literacy for the 21st Century
  • Literacy involves a complex set of abilities to
    understand and use the dominant symbol systems of
    a culture for personal and community development.
    The need and demand for these abilities vary in
    different societies.
  • In a technological society, the concept is
    expanding to include the media and electronic
    text in addition to alphabets and numbers.
  • Individuals must be given life-long learning
    opportunities to move along a continuum that
    includes reading, writing, and the critical
    understanding and decision-making abilities they
    need in their communities.
  • The center for literacy of Quebec
    http//www.nald.ca/province/que/litcent/litWD.htm

46
QUALITY JUDGEMENT
  • Healthy People 2010 Objective 11-4
    (Developmental) Increase the proportion of
    health-related World Wide Web sites that disclose
    information that can be used to assess the
    quality of the site.
  • Potential data sources Health on the Net
    Foundation Health Internet Ethics (Hi-Ethics)
    Internet Healthcare Coalition.
  • National Educational Technology Goal 4 Research
    and evaluation will improve the next generation
    of technology applications for teaching and
    learning.
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