Health Education Health Education in the Community in the Community

Theoretical BasesTheoretical 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 people’s health

Theoretical Bases: ConceptsTheoretical Bases: Concepts

Advocacy Barriers Benefits Cognitive

dissonance

Empowerment Motivation Readiness Self-efficacy

Theoretical Bases: Theoretical Bases: Learning TheoryLearning 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

Theoretical Bases: Theoretical Bases: Learning TheoryLearning 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

Theoretical Bases: Theoretical Bases: Behavior Change TheoryBehavior Change Theory

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

Transtheoretical ModelTranstheoretical Model

Precontemplative Contemplative Preparation Action Maintenance Relapse

Processes to Enhance Processes to Enhance Progression Through StagesProgression Through Stages

Consciousness raising

Dramatic relief Environmental

reevaluation Self-reevaluation Self-liberation

Helping relationships Social liberation Counter conditioning Stimulus control Reinforcement

management

The Health Education ProcessThe 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)

Assessment: What to AssessAssessment: 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

Assessment: What to AssessAssessment: What to Assess

Self-efficacy Perceived benefits

to change Perceived barriers

to change Psychosocial issues Learning skills

PlanningPlanning

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

Domains of LearningDomains of Learning

Cognitive

Psychomotor

Affective

ImplementationImplementation

Design teaching based on assessments of individual clients

Develop educational objectives with input from the learner

Create a learning environment Keep things simple

ImplementationImplementation

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

ImplementationImplementation

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

ImplementationImplementation

Develop mechanisms for support Discuss resources for further information Review major points of each learning

session Keep learners involved: Ask for feedback

and evaluation

EvaluationEvaluation

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

Health Education Health Education in Communitiesin Communities

Individuals, families, & groups Discharge

teaching Community-

based teaching

Advantages to Teaching in Advantages to Teaching in Client’s HomeClient’s Home

Nurse can assess the client’s 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

Advantages to Teaching in Advantages to Teaching in Client’s HomeClient’s 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

CommunityCommunity

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

CommunityCommunity

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

Ethical Issues Ethical Issues in Health Educationin 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