Health Education

Introduction
1. Objectives
  1. Informing People
    1. Cognitive objective
  2. Motivating People
    1. Affective objective
  3. Guiding into Action
    1. Behavioral objective
2. Principles OF HEALTH EDUCATION
  1. Credibility
    1. The degree to which the message is perceived as trustworthy by the receiver.
  2. Interest
    1. The health educator should identify the felt needs of the people and prepare a program so that they actively participate in to make it successful
  3. Participation
    1. Health educator should encourage people to participate in the program
  4. Motivation
    1. Fundamental desire for learning in an individual
  5. Comprehension
    1. Level of understanding of the people who receive the health education.
  6. Reinforcement
    1. Repetition needed in health education
  7. Learning by doing
    1. If the learning process is accompanied by doing the nee things, it is better instilled in thr minds of the people
  8. Known to Unknown
    1. The existing knowledge of then people can be used as the basic step upon which new knowledge can be placed
  9. Setting an Example
    1. Health Educator should follow what he preaches
  10. Good Human Relations
    1. Health educator must have good personal qualities and be able to maintain friendly relations with people
  11. Feedback
    1. Collect feedback to find out if any modifications are needed to make the program more effective
  12. Community Leaders
    1. Used to reach the people of the community and to convince them about the need for health education.
  13. Soil, Seed, Sower
    1. Soil - people
    2. Seeds - Health facts or health education
    3. Sower - Media
APPROACHES
1. Regulatory approach (Managed prevention)
  1. Defined as any Governmental intervention
  2. Coercive approach or Legislative approach
  3. Useful in times of emergency
2. Service approach
  1. Providing health services at peoples’ door step
  2. Not based of felt needs
3. Health education approach
  1. Slow but enduring results
4. Primary health care approach
  1. Radically new approach
  2. Community involvement and intersectoral coordination
  3. Help individuals becomes self reliant in health
HEALTH EDUCATION VS PROPAGANDA
1. HEALTH EDUCATION
  1. PROPAGANDA
2. Knowledge and skills are actively acquired in this process
  1. Knowledge is instilled in the individual's mind in this process
3. Drives people to think for themselves
  1. Contains ready made slogans which prevents thinking in individuals
4. Primitive desires are disciplined in this process
  1. Primitive desires are stimulated and aroused
5. Results in a reflective behavior and makes people to use judgement before acting upon it
  1. Results in reflexive behavior and makes people to aim at impulsive actions
6. The process appeals to reason
  1. The process appeals to emotion
7. Helps in developing individuality, personality and self expression
  1. Develops different patterns of attitudes and behaviors according to the medium used.
8. Knowledge is acquired through self reliant activity
  1. Knowledge is received passively received and is spoon fed
9. Entire process is aimed at developing good habits, favorable attitudes and skills in individuals and is behavior oriented
  1. Entire process brings no change in individual's attitude or behavior and is information oriented
METHODS of health education
1. Individual Approach
  1. Personal contact Personal letters Home visits
  2. Opportunity for asking questions and clearing doubts
  3. Only a small number an benefit
2. Group Approach
  1. Effective way of educating the community
  2. Lectures
    1. Carefully prepared oral presentation of facts, organized thoughts and ideas by a qualified person
    2. One way communication - Didactic
  3. Symposium
    1. A series of speeches on a selected topic
    2. Two way communication Socratic method
  4. Group discussion
    1. A group of 6-12 people interacting on a face-face situation
    2. Two way communication Socratic method
  5. Panel discussion
    1. Panel of 4-8 experts discuss a topic in front of an audience
    2. No specific agenda, no order of speaking and no set speeches
    3. Two way communication Socratic method
  6. Workshop
    1. Series of meetings with emphasis on individual work with the help of resource persons
  7. Conference / Seminar
    1. Contains a large component of commercialized continuing education
    2. Programs based on a theme held on a regional/state/ national level
  8. Role playing/ Socio drama
    1. The situation is dramatized to make communication more effective followed by discussion of the problem
  9. Demonstration
    1. Procedure is carried out step by step in front of an audience
    2. Upholds principles of ‘seeing is believing’ and ‘learning by doing’
3. Mass Media Approach
  1. Effective way of educating the general public
  2. Television
    1. -Most popular of all media – Creates awareness, influence public opinions and introduce new ways of life
  3. Radio
    1. Purely didactic medium
  4. Internet
    1. Fast growing communication media
  5. Newspapers
    1. Most widely disseminated of all forms of literature
  6. Printed material
    1. Can convey detailed information
  7. Direct mailing
    1. New innovation in health communication
  8. Posters, billboards, signs
    1. Can be displayed at public places
  9. Health museums and exhibitions
  10. Folk media
Other Key Points
1. Atraumatic Restorative Treatment
  1. Pioneered in mid 1980 in Tanzania
  2. A community field trial was first started in Thailand in 1991
  3. 2 Main Principles
    1. Removing various tooth tissues using hand instruments only
      1. •Low cost od hand instruments •To prepare minimal cavity •To avoid LA •Simple sterilization steps for hand instruments
    2. Restoring the cavity with a restorative material that sticks to tooth
      1. Preferably GIC because • Biocompatibility • Fluoride release • Chemical binding to enamel and dentine
  4. Indications
    1. Only small cavities involving dentin , that are accessible to hand instruments
    2. In public health programs
  5. Contraindications
    1. Pulp exposed tooth, that is painful for long time and there may be chronic inflammation of the pulp
    2. Presence of swelling/ fistula near the various tooth
    3. Obvious various cavities but the opening is inaccessible to hand instruments
2. Preventive Resin Restorations
  1. Description
    1. Natural extension of the use of occlusal sealants
    2. Integrates the preventive approach of the sealant therapy for caries susceptible pit and fissure with therapeutic restoration of incipient caries with composite resin that occur on the same occlusal surface
  2. Simonsen Classification 1978
    1. TYPE A
      1. Suspicious pits & fissures where caries removal is limited to enamel
      2. LA not required
      3. A slow speed round bur used to remove decalcified enamel & sealant placed
    2. TYPE B
      1. Incipient lesion in dentin that is small & confined
      2. LA not required
      3. An appropriate base is placed in areas of dentin exposure, composite resin is placed & the remaining pit & fissure are covered with a sealant
    3. TYPE C
      1. More extensive dentinal involvement & requires restorations with posterior composite material
      2. LA is required
      3. An appropriate base is placed over dentin
      4. Pit & fissure are covered with a sealant
Models of Health Education
1. Cognitive model
2. Social Cognitive Model
3. Theory of reasoned action
4. Stages of changed model
5. Health belief model (Rosen stock)
  1. Considers factors such as
    1. Readiness to act
    2. Performing a behavior based on perceived costs and benefits
    3. Cues to action
  2. Beneficial in assessing health protection or disease prevention behaviors
6. Health Promotion Model
7. Behavioral leaving Model
8. Self care motivation model
  1. Horowitz and Associates
9. Precede Proceed Model
  1. Precede Predisposing Reinforcing and Enabling Constructs/ Causes in Educational and Environmental Diagnosis and Evaluation
  2. Proceed Policy Regulatory and Organizational Constructs in Educational and Environmental Development
10. Contemporary community health model
Counselling
1. Face-to-face communication through which a person is helped to make a decision or solve a problem
2. Choice is given to clients
3. Elements of Counselling
  1. GATHER Approach G: Greet A: Ask T: Tell H: Help E: Explain R: Return visit
Changing concepts of Health Education (Alma – Ata Declaration, 1978)
1. Older emphasis
  1. New emphasis
2. Prevention of disease
  1. Promotion of healthy lifestyles
3. Modification of individual behaviour
  1. Modification of social environment
4. Community participation
  1. Community involvement
5. -
  1. Promotion of individual & community self reliance