Health Education in the Community

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Health Education in the Community
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Theoretical Bases

• Theories describe, explain, and predict behaviors
  within a functional framework
• Theories about health education and behavior
  change help nurses understand behavior and
  develop useful strategies that influence peoples
  health

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Theoretical Bases Concepts

• Advocacy
• Barriers
• Benefits
• Cognitive dissonance

• Empowerment
• Motivation
• Readiness
• Self-efficacy

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Theoretical Bases Learning Theory

• Assumptions of adult learning theory
• Adults perceive themselves to be self-directed
  They want to have a say in what they learn
• Adults have a variety of life experiences and are
  insulted if these experiences are ignored The
  wise teacher will build on these experiences

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Theoretical Bases Learning Theory

• Assumptions of adult learning theory
• Adults learn better when they see an immediate
  need They are goal directed
• Timing education to coincide with an immediate
  need is more effective because the learner will
  see the immediate goal and be ready to learn

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Theoretical Bases Behavior Change Theory

• Health belief model
• Harm reduction model
• Goal-setting theory
• Theory of reasoned action
• Social learning theory
• Diffusion theory
• Social marketing theory

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Transtheoretical Model

• Precontemplative
• Contemplative
• Preparation
• Action
• Maintenance
• Relapse

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Processes to Enhance Progression Through Stages

• Consciousness raising
• Dramatic relief
• Environmental reevaluation
• Self-reevaluation
• Self-liberation

• Helping relationships
• Social liberation
• Counter conditioning
• Stimulus control
• Reinforcement management

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The Health Education Process

• Health education is a process of planned teaching
  and support activities that help people learn
• The education process follows the format of the
  nursing process (assessment, planning,
  implementation, and evaluation)

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Assessment What to Assess

• Client understanding of the problem in question
• Client perception of need to change
• Motivation to change severity of problem and
  risks caused by the problem
• Readiness to change

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Assessment What to Assess

• Self-efficacy
• Perceived benefits to change
• Perceived barriers to change
• Psychosocial issues
• Learning skills

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Planning

• The nurse and client discuss learning needs and
  goals and then negotiate to produce a list of
  learning objectives
• The goals and objectives provide direction for
  implementation and guide evaluation
• Objectives are specific and measurable
• Objectives address different domains of learning

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Domains of Learning

• Cognitive
• Psychomotor
• Affective

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Implementation

• Design teaching based on assessments of
  individual clients
• Develop educational objectives with input from
  the learner
• Create a learning environment
• Keep things simple

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Implementation

• Focus on one issue at a time
• Be sure written materials are appropriate
• Be specific
• Avoid threatening messages that generate fear
• Explain what you will be teaching and why it is
  important

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Implementation

• Provide for success
• Use a variety of teaching methods
• Provide visual learning materials
• Show the client what is expected
• Skills require practice
• Involve all senses in practice sessions

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Implementation

• Develop mechanisms for support
• Discuss resources for further information
• Review major points of each learning session
• Keep learners involved Ask for feedback and
  evaluation

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Evaluation

• Evaluation is a process of gathering information
  to assess the extent to which learning objectives
  have been met or not met
• All evaluation methods should be based on the
  learning objectives
• Summative evaluation
• Formative evaluation

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Health Education in Communities

• Individuals, families, groups
• Discharge teaching
• Community-based teaching

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Advantages to Teaching in Clients Home

• Nurse can assess the clients environment and
  make changes to the teaching plan to compensate
  for problems and to take advantage of strengths
• The family can be more easily involved

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Advantages to Teaching in Clients Home

• The client will usually be more comfortable in
  his or her own environment
• The client will be learning in the environment in
  which he or she will be using new information to
  perform new skills and behaviors

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Community

• Health education at the community level begins
  with community assessment
• Planning requires community involvement
• Encourage an implementation process that helps a
  community meet its own needs
• Effective evaluation determines progress toward
  goals and identifies goals not met

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Community

• Data from evaluation are used to
• Determine if unmet goals are still a priority
• Plan interventions to address unmet goals
• Assess the impact of goals that have been
  achieved
• Assess evolving needs
• Establish new community goals and objectives

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Ethical Issues in Health
Education

• Manipulation of behavior versus information
  dissemination
• Obligation of nurses to keep up with advances in
  health care
• Social and economic barriers related to growing
  gap between classes
• Community and cultural norms