KINS3313 Lesson 1: Intro to Health Education and Health Promotion

okay folks uh

welcome to kins 3313 health promotion

program planning um

you know my name is jim lidstone and i'm

a faculty member here at georgia college

and i've been teaching this course now

for

for quite a few years and we do it both

in the regular spring semester and then

in a shortened uh

version of maymester

in both of those cases i want to try to

get students involved out in the

community and do

something meaningful

you know so so we can help our community

but we'll also learn through doing

so um what i want to try to do this

semester is to

post a lot of these narrated powerpoint

presentations

i've usually posted the presentations

but have gone over the

the material in class but what i'd like

to try to do this semester is

post these presentations ahead of time

with narration so that you can look at

them and we can spend

our time in class you know planning

health promotion programs and applying

the materials that we learn through the

lessons

so with that in mind let's get started

and get into lesson one

all right so lesson one deals primarily

with concepts and terminology it

corresponds to the first chapter in the

book and so we're going to be talking

about health education

health promotion a broader term uh

concept of health education specialists

and program planning

all right so uh here are the learning

objectives for the for this lesson and

i'd like you to take a look at those i'm

not going to spend time reading through

them but

i think it's a good idea to go through

the lesson and then after you've done

that come back to the learning

objectives and

determine how well you feel that you

meet those um so for example for the

the third one write your own definition

of health education you know don't just

say oh yeah i can do that you know

actually go ahead and do it and

test yourself and

and uh i think you'll find that it's

more difficult than it sounds and it's a

good way of determining whether or not

you're understanding the material is to

uh you know do uh do a check on these

learning objectives

okay so here's some of the terminology

in the chapter and you can use this as a

way of studying for the quizzes that

you're going to have later but

you know terminology like decision

makers health behavior health education

health educator

health education specialist health

promotion

the different levels of prevention

primary secondary and tertiary

prevention

priority population and stakeholders

those are all things that we want to

make sure that we understand

once we're finished with lesson

okay so uh why do we need health

education or health promotion here's a

list of

of

factors from a table that's on page two

of the first chapter of the book

on the left hand side of the column

would be the causes of death in the

united states that you would typically

see on a death certificate for someone

who's passed away

but on the right hand side are you know

what the actual causes of death would be

so you know somebody may

uh succumb to heart disease but really

when you look at the you know the real

causes of that you know most of those

causes are behavioral so people are not

taking care of themselves

too much stress in their life

you know not eating right not exercising

you know those are the real causes of

you know a person that passes as a

result of cardiovascular disease and so

as health educators and health promoters

we want to address those those causes as

opposed to the things that we see on the

death certificate

in fact we even want to drill down

deeper than than those causes and try to

find out okay what

um you know what are the the real causes

for a person not eating properly you

know it may be that they don't have

access to healthy food in their

neighborhood they live in a so-called

food desert so you know those things

even go deeper than just failing to

consume you know the proper kinds of

food

so let's keep that in mind as we as we

continue to move forward

all right so uh this graph shows how

things have uh

you know really turned on their heads

since the turn of the century or turn of

the 19th

the 20th century i mean

so you know back in the 1900s and all

the way through to you know about 1940

or so you know our primary concern in

health education health promotion was on

infectious diseases

so things like uh diphtheria smallpox um

you know those kinds of things you know

those were causing the the major issues

uh you know in the in the nation

and so

gradually we've gotten those things

under control through uh vaccination

programs and things like that

but what's happened is you know with a

corresponding decrease in infectious

disease what we've seen is a is an

increase in

uh chronic disease so things like

obesity diabetes uh cardiovascular

disease stroke you know all of those

things are on the rise and continue to

be on the rise

so you know rightly so we've turned our

attention more since you know the 1970s

or so to

chronic diseases as opposed to

infectious diseases

okay so this uh you know kind of shows

um you know kind of chronicles the um

our efforts in health education so in

the late 1800s all the way through 1950

we were focusing on the infectious

diseases

then in the 1950s and 60s

we brought those infectious diseases

primarily mostly under control

and then in the 70s we started to turn

our attention more to the chronic

diseases in 1980 the first major uh

health promotion effort called promoting

health preventing disease objectives for

the nation was

developed by the us department of health

education and welfare

and then that morphed into the healthy

people initiatives that i know you've

probably heard about healthy people 2000

2010 and 2020.

we're now of course in

in the midst of healthy people 2020

you know what we typically find at the

end of those periods is that

um

you know in terms of the objectives

about 30 percent we make progress on

about 30 percent it's status quo we

haven't made any progress in about 30

percent we even are going in the in the

wrong gym

so when we plan our pro health promotion

efforts it's always a good idea to link

them to

something like a

a state health initiative

live healthy georgia is a health health

initiative for the state healthy people

2020 health initiative for the nation it

helps to give your efforts credibility

if you can tie those into some major

state or national health promotion

efforts

all right so let's get into some

terminology

in this chapter you'll you'll read about

health health behavior health education

and health promotion so let's take a a

few minutes and look at those

a good again a good

learning activity is and a check for

understanding is to come up with your

own definitions of health health

education health promotion

you can look at the the textbook and get

some ideas but

i think it's always a good idea to put

things into your own words and that

helps with learning

all right so uh what is health um it's a

pretty common common definition of

health here as a combination of physical

mental social emotional and spiritual

factors

you know those are commonly known as the

five dimensions of health

i think i've even seen a couple of other

dimensions added like occupational and

intellectual

but you know these are the common ones

physical mental social emotional and

spiritual so

we're looking for a balance among those

factors that enable an individual to

live to his or her

optimal capabilities

and then health education you know

health education is the things that we

do that

enable an individual to make good

choices

and so if we look at a definition here

the continuum of learning that enables

people individuals and as members of

social structures because we don't just

exist in isolation

to voluntarily make decisions modify

behavior and change social conditions in

ways that are health enhancing

so again thinking in terms of

we want to do things to make um

make the healthy choice the easy choice

that's kind of the motto of live healthy

baldwin which is the childhood obesity

prevention approach program that i've

been managing for the last six or seven

years but you know that's what we try to

do is make the healthy choice the easy

choice

all right so another uh definition of

health education uh and i've highlighted

some words here that um i think are

important in the definition but it's a

combination of learning experiences so

no one thing is going to do the trick so

we want to use a variety of different uh

learning activities and they're designed

so it's not haphazard it's not

you know something that we do off the

cuff it's something that we do

intentionally

give it a lot of thought and then what

we're trying to do is facilitate

individuals making

voluntary choices that are

conducive to their health

and then health promotion health

promotion is a a broader term than

health education health education is

part of health promotion

but when we talk about health promotion

we're talking more about the

kind of the macro level more about the

the environment you'll hear me talk

about pse policy systems and

environmental change

so those are things that we deal with in

health promotion and

you know it's important for the

environment to be conducive for an

individual to be able to make a behavior

change so

you know health promotion again that

combination of health education and

related organizational political and

economic interventions designed to

facilitate behavioral and environmental

adaptations that will improve or protect

health

so the word economic is in there too

because with a lot of the chronic

diseases that we deal with obesity

diabetes cardiovascular disease

those are called diseases of the poor um

they are

different they differentially affect low

income and particularly low-income

monies

so um you know there's definitely a

relationship between income and health

status and the wealthier you are the

better your health outcomes are

typically so we need to

be concerned with all of these things

these organizational political and

economic strategies when we do health

promotion

uh continuing on with health promotion

again you see the idea of combination uh

educational is part of it but also

ecological and ecological again refers

to the total social system

you know later on in the semester you'll

hear us talk about

the social determinants of health you

can google that if you like but you'll

find out that the real causes of health

problems are much deeper than just

surface causes like you know not

exercising or

you know not eating the right way so we

need to focus on the the big picture in

order to make meaningful sustainable

changes to

the health environment

all right so last thing that they'll

leave you with here in terms of health

promotion again it's the aggregate which

means the collection of all purposeful

or intentional activities that are

designed to improve personal and public

health through a combination of

strategies

again no one thing is going to do the

trick we need to look at a variety what

we call multi-intervention strategies

uh and intervene at multiple levels to

have the biggest impact

so we're trying to implement behavior

change strategies health education

health protection measures

you know if you wore your your safety

belt when you drove to school today you

know that is a health protection measure

there's a law that was put in place to

encourage you to do that

so you know that's a part of health

promotion risk factor detection health

screenings mammograms

self-exams things like that are designed

to

detect whether or not you're at risk

whether you have a condition and then

health enhancement and health

maintenance

all right so we've talked about

health education and health promotion

now what about health educators so

you are being prepared to be health

educators when you finish with your

program you would be certain eligible to

sit for the

the chess exam which you may have heard

of ches stands for certified health

education specialist there's also the m

chas which is a master's certified

health education specialist after you've

gone through a graduate program

but basically you're qualified as a

health educator if you go through a an

accredited institution a moved program

uh curriculum that has all of the

knowledge and competency areas in it and

that's taught by qualified faculty

members

so

you know this comes from the joint

commission on terminology as part of

something that was called the role

delineation project back in the

1990s and early 2000s

which defined the preparation for health

educators

so a professionally prepared individual

who serves a variety of roles and will

look at those roles in in

a little bit specifically trained 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

all right so uh health education is

delivered in various settings uh so i

want to pause for a second and ask you

to kind of reflect on where you think

health education gets delivered

you know what are some health education

settings

all right so you may have thought of

some of these already

you know if you're working with

individuals

young individuals you know you probably

are focusing on the schools

so the schools are a health education

setting for k through 12

you know for colleges and universities

we have a health educator here on campus

rachel pope and she's over in student

health but she does health education in

a variety of different places at the

universities fraternities sororities

coming to classes

and so on and so forth

health education also takes place in

governmental and non-governmental

agencies

so you know defects for example

the baldwin county health department

those places where health education

could happen

if you're working with adults you know

most adults during the day or at work

and so work sites can be a health

education setting and then of course you

have various health care settings like

doctors offices clinics hospitals

and so on

okay so again the role delineation

project that i mentioned earlier

identified

some areas of responsibility and

competency for health educators

and these are

extremely relevant to what we're going

to be doing this semester in health

promotion program planning

there's a lot of detail behind these

roman numeral items but we won't go into

those but we'll just look at the basic

categories here so number one is being

able to assess individual and community

needs for health education

so you have to identify what the problem

is and what the causes of the problem

are before you can actually do something

about it

and number two is plant education

strategies interventions and programs to

meet those needs that you identified in

number one

and then implementing those strategies

interventions and programs that's a

logical next step and then conducting

evaluation and research related to

health education and health promotion

so we want to determine you know whether

or not our strategies have been

effective and you know where we go from

there

and then number five is administering

health education strategies

interventions and programs

six serving as a resource person for

individuals and communities and then

finally communicating and advocating for

health and health education

so all of these are part of what a

health educator

should be able to do once they

finish an academic program at a an

institution of higher learning

okay so i want to stop here and uh tell

you a little story uh ask you to to use

your imagination

and imagine that you're

walking along the banks of a river

with with two of your friends

and so um

you know

we have a river that goes past our

community the oconee river you know

maybe you've been down to the greenway

but i'm sure you can use your

imagination and and just visualize

yourself walking along the banks of the

river

all right as you walk along the river

you start to hear in the distance say a

growing roar that roar is

the sound of water going over a

waterfall and it's not just a little

waterfall we're talking about a big

niagara falls type waterfall where if

you were to go over the waterfall

uh you know certainly it would be

you know very hazardous to your health

and probably even would result in death

and so as you walk along the river you

look out into the river and you see

people

floating down the river

you know some are a long way from the

fall some are getting closer to the fall

some are

in immediate danger of going over the

falls

and so

you and your friends decide that

something needs to be done

and so one of your friends says we need

to go down further towards the falls and

we need to get the people that are in

imminent danger of going over the falls

and another person says well

you know i don't think that's

going to be very productive because

those people are probably goners anyway

we need to focus on the folks that are

here in front of us that are are not

there yet but uh are in danger of

getting to that point

and the other person doesn't say

anything but they just kind of turn on

their heels and start going back

upstream

and the two friends that are with this

person are you know kind of dismayed and

they say where are you going where are

you going and the person says well i'm

going to go find out

how these people are falling in the

river and i'm going to stop that from

happening

so let that sink in for a second

you know it uh

it's kind of illustrative of

our different levels of prevention that

we go through in in health education

health promotion the primary the

secondary and the tertiary levels and so

let's uh take a look at

okay so primary prevention is we're

trying when we're trying to keep illness

or injury from happening at all in the

first place so the person that was going

back upstream

uh you know they were gonna figure out

why the problem was happening and they

were gonna solve the problem upstream

secondary prevention that's kind of

equivalent to people have already fallen

in the water they're already in danger

uh they're drifting towards the falls

but we're not there yet we're going to

see what we can do about keeping it from

getting any worse

and then finally the tertiary prevention

where we have to do drastic measures

after something has happened

to prevent an individual from

experiencing severe

illness disability or even death

so here's a chart that

you know kind of shows these things a

healthy individual without signs and

symptoms of disease

followed by a person who does have

signs of of illness

disease or injury

and then that if left unchecked is going

to result in

problems severe problems disability

impairment

and

tendency

and then finally again if left unchecked

it's ultimately going to result in death

so what we want to do is we want to

intervene between these stages and so

primary prevention would be keeping an

individual healthy doing the measures

that takes to uh to keep illness or

injury from happening

and in the event that you know we start

to see signs and symptoms of illness uh

disease as we all seem to to get as well

then we need to engage in secondary

prevention and that could be medications

it could be changes in diet things like

that to

try to keep things from getting worse

and then finally if something does

happen then we go to our our medical

professionals our doctors and so on

to do more drastic measures to keep

things from getting to the to the end

point

all right so uh here's a there's a place

to check your understanding of the

concepts of primary secondary and

tertiary prevention uh here's a list of

of things uh from you know exercise open

heart surgery to mammograms and so on uh

see if you can correctly classify each

of these as primary secondary or

tertiary some are obvious some are you

know kind of gray areas i'm not sure

there's a right or wrong answer for some

of these depending on how you're

how you're using it and where you're

using it in the stage of disease

progression but

it's a good way to check for

understanding to see if you've got it

all right so in order to

engage in health promotion there are

certain things that certain principles

that we need to adhere to or agree to

call those assumptions of health

promotion

so first and foremost you have to

believe that health status can be

changed um

you know i think if we don't believe

that we can change individuals health

status then you know we're really

in the wrong business we're probably

wasting our time

another thing that we assume is that you

know health and disease are determined

by

complicated processes dynamic

interactions among biological

psychological behavioral and social

factors the more we know the more we

understand that

you know health

status is a complex thing and it's

determined by a lot of different factors

third thing is we need to assume uh or

hold to the belief that disease

occurrence theories and principles can

be understood

um you know we know a lot more today

than we knew 50 years ago and 50 years

from now we're going to know a lot more

than we do today

but the idea is that we do

understand you know at least where we

are today

that

there are theories uh there are

principles about how people get diseases

we understand causes we understand those

factors and we can go from there

number four is that appropriate

prevention strategies can help to deal

with those health problems and if you

don't believe that then there's no sense

going forward

but we do have what we call best

practices

that have been developed to deal with

strategies and we need to

adhere to those best practices and

continue to develop new stress

number five we need to believe that

behavior can be changed and that those

changes can influence health

um you know anybody who's tried to

change a behavior uh knows that it's not

easy

that it takes time

but anybody that has changed the

behavior knows that it can be done so um

you know like i say it's not easy but we

do

uh continue to believe that we can

influence people to make good choices

and to change their behavior

number six is that it's it's complicated

and that there are a lot of different

factors that come to bear on it so

our individual behavior our family

interactions the community that we live

in workplace our relationships resources

and public policy all contribute to

health and influence behavior change

so again we adopt that assumption and so

our strategies need to be directed at

those multiple uh multiple levels

multi-intervention strategies at

multiple levels are going to be more

effective than you know individual

single strategies directed at you know a

single level

hope that makes sense

you know we had the the pleasure of

having two daughters get married within

nine months of each other and so we had

a lot of planning that took place months

and months in advance of an event that

lasted probably a few hours the ceremony

itself you know maybe

40 45 minutes tops and then the

reception a couple of hours three hours

whatever after that and so

you know contrast the months of planning

uh for the fairly short activity itself

and you can see what all needs to go

into it and sometimes we hire

professionals sometimes you hire a

wedding planner you use planning tools

to help make sure that you don't forget

anything that you've covered all your

bases again all so that

the actual program itself goes off well

it goes off without a hitch

okay so some more terminology just to

sort of wrap that up in the in this

chapter in this lesson we have the idea

of stakeholders decision makers

pre-planning and the priority population

so your stakeholders are

all of the individuals all of the

organizations all of the agencies that

have a vested interest in the things

that you're trying to do

so this week you'll either have already

been to the harrisburg community or

you'll be going to the harrisburg

community

every tuesday

you know 30 to 40 people gather around

those tables and they've been doing that

for several years now because they all

care about the community and the things

that are happening out there and they

want to have a voice they're

stakeholders they're either individuals

that live in the community or have lived

in the community

they're representatives of organizations

or agencies like the millageville

community garden association

central georgia technical college

various churches that are in the

community

georgia college representatives are

there

baldwin county connection habitat for

humanity all of those folks are what we

would call stakeholders

and then you have decision makers you

have people that are in positions of

power that control access to resources

and

control

you know the types of policies that we

put in place

again you will

be meeting or will have met commissioner

tommy french who's a the baldwin county

commissioner he represents the

harrisburg community

and

harold simmons who's a measure member of

the board of education he's also a long

time resident of

the harrisburg community and has a

business that's based out of there so

those are folks that you have to get on

your side because they're the ones that

will allow you to do or advocate for the

kinds of things that you want to do

you've got to get those people on your

side

pre-planning means the things that we do

prior to uh to planning getting involved

and that usually includes you know

developing relationships developing

trust gaining um access to a community

uh so that you know our our efforts can

be well received and then the priority

population

in older literature you might re see it

referred to as the target population uh

priority population is the group of

individuals that you want to be working

with in our circumstances

you know the priority population are

usually people that

for one reason or another are not

capable of helping themselves don't have

the resources to help themselves don't

feel empowered to be able to help

themselves and so that's what we try to

do is we try to work with the

underserved prop population

typically

disadvantaged in some way

economically educationally

and so you know what we try to do is

help those individuals

move their communities forward to

benefit their health

okay so um

the last thing that we'll talk about

here uh in this chapter and it kind of

bleeds over into

lesson number two about planning models

is something called the generalized

model for program planning and it

outlines the steps that we need to go

through in order to implement in order

to plan for health promotion

and so

step number one assessing the needs of

the priority population and then once

you've identified and prioritize those

needs then you establish your goals and

objectives for what you want to

accomplish

uh you select or develop the

interventions that are going to allow

you to

you know to meet those goals and

objectives and then finally implement

those interventions and evaluate the

results

determine what's gone well what hasn't

gone well and then typically the cycle

starts all over again

as we

identify new needs or

you know try to meet needs that we

didn't meet

the first time around

and then the

at the bottom there i asked about what

about understanding engaging the

priority population should that be a

step where does it fit

in some books that describe the

generalized planning model they'll have

a preliminary step that says

understanding and engaging the priority

population i already talked about that

in terms of what's what we call

pre-planning and i think it is a very

important and necessary step because

uh unless you're accepted unless you

develop relationships unless you build

trust

you know you're not going to do a very

good job of

of

health promotion in a community where

you're not accepted

okay so finally i encourage you to go

back and take a look at the learning

objectives for this lesson

you know actually try to do some of

these things and determine whether or

not you feel like you

understand the material

go back in and do the reading or re-read

feel free to

ask me any questions that you might have

about the material and

and we'll

end it here today and

look for lesson number two next week

thanks a lot