THEORIES IN HEALTH EDUCATION

THEORIES IN HEALTH EDUCATION

1) Health Promotion Theory
 Nola J. Pender
 Developed the Health Promotion Model
 According to Pender:
 Health Promotion and Disease Prevention should be the primary focus in health care, and when
health promotion and prevention fail to prevent problems, then care in illness becomes the next
priority.

Health Promotion
 Defined as behavior motivated by the desire to increase well-being and actualize human health
potential.
 It is an approach to health.

Health Protection or Illness Prevention

 Described as behavior motivated desire to actively avoid illness, detect it early, or maintain functioning
within the constraints of illness.

Nursing Practice
 According to Pender:
 “We are moving toward an era of science-based practice in nursing that incorporates the latest
findings from the behavioral and biological sciences into practice to assist people of varying
cultural backgrounds to adopt healthy lifestyles.”
 “Prevention is better than cure.”

Community Health Care Setting

 Best avenue in promoting health and preventing illness.
 Using Pender’s Health Promotion Model, community program can focus on activities that can improve
the well-being of the people.
 Example:
 Students taught the family the value of eating a balanced diet and the disadvantages of vices
such as: smoking and drinking alcoholic beverages.

2) Precede-Proceed Model
 Developed by Lawrence W. Green
 It is a cost benefit evaluation framework that can help health program planners, policy makers, and
other evaluators analyze situations and design health programs efficiently.
 Active participation of the community that will take an active part in defining their own problems,
establishing their goals, and developing their solutions

2 Distinct Parts of the Precede-Proceed Model

1. Educational Diagnosis (PRECEDE)
 Predisposing
 Reinforcing
 Enabling
 Constructs in
 Educational
 Diagnosis and
 Evaluation

2. Ecological Diagnosis (PROCEED)

 Policy
 Regulatory and
 Organizational
 Constructs in
 Education
 Environmental
 Development

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 THE PRECEED-PROCEED MODEL
Definition: ________
PHASE 1 Causes: _________
Social Problems Signs and Symptoms: _______
PHASE 2
Consists of identifying the health determinants of these problems and needs.
Health Determinants
PHASE 3
Involves analyzing the behavioral and environmental determinants of the
Environmental or
health problems
Behavioral Determinants
PREDISPOSE:
Any characteristics of a person or population that motivates behavior prior to
occurrence of that behavior. They include individual knowledge, belief, values
and attitudes.

ENABLES:
PHASE 4
Those characteristics of the environment that facilitate action and any skill or
Factors that Predispose,
resource required to attain specific behavior.
Reinforce, and Enables
They include programs, services, availability & accessibility of resources or
Behavior Change
new skills required to enable behavior change

REINFORCE:
Rewards or punishment following or anticipated as consequence of behavior.
The serve to strengthen the motivation for behavior. They include social or
peer support etc.
PHASE 5
Health Education/ Involves ascertaining which health promotion, education or policy related
Prevention/ Promotion/ intervention would best be suited to encourage behavioral or environmental
Policy best suited to changes and factors that support those behaviors and environment.
Behavior Change
PHASE 6
Evidenced based interventions identified in Phase 5 are implemented.
Interventions
PHASE 7
Evaluation of It entails process evaluation of those interventions.
Interventions
PHASE 8
It involves evaluating the impact of the interventions on the factors supporting
Evaluating the Impact of
behavior and on behavior itself.
Interventions
PHASE 9
Outcome Interventions Comprises outcome evaluation that is determining the ultimate effect of the
Determining the Effect of interventions on the health and quality of life of the population.
Interventions

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 THE PRECEED-PROCEED MODEL (EXAMPLE)
 Definition: Early Pregnancy
PHASE 1  Causes: _________
Social Problems  Signs and Symptoms: _______
 Nursing Interventions: Books and References

 Lack of guidance from parents

PHASE 2
 Lack of information on safe sex
Health Determinants
 Over family size.
PHASE 3  Influence by friends/peers
Environmental or  Parent’s aren’t good role model
Behavioral Determinants  Exposure/ access to view pornographic materials
PREDISPOSE:
 Disobedient to parents and elders
 Teens are more focus to their peers, love life than their studies
 Teenage couple seek security in relationship
 Curiosity and sexual aggressiveness
PHASE 4 ENABLES:
Factors that Predispose,
 Conduct sexuality and reproductive health education in school
Reinforce, and Enables
 Proper guidance/monitoring of parents
Behavior Change
 Teenage/Adolescent organization

REINFORCE:
 Close family ties
 Impose discipline
 Good peer group influence
 Counseling (couple, parents, family)
PHASE 5
 Mobilize/Organize Community Participation Group (Youth Peer
Health Education/
Educators
Prevention/ Promotion/
Policy best suited to  Network-Family Planning, Organization of the Philippines (Y-PEER-
Behavior Change FPOP), Council for the Welfare of Children (CWC), and Lunduyan
Foundation
 Don’t give in to peer pressure.
PHASE 6
 Learn to say no.
Interventions
 Use protection with the use of contraceptives.
PHASE 7  Every teenager should know its limitations especially when it comes to
Evaluation of relationship.
Interventions  Proper knowledge about contraceptives
 Every individual has its own freewill and understanding to choose, don’t
let others/ peers influence you especially having sex not on time.
PHASE 8
 The only 100% safe to avoid pregnancy in not to have sex.
Evaluating the Impact of
 With proper knowledge in using contraceptives may lessen the
Interventions
incidence of teenage pregnancy.
 Value of self-control and respect.
PHASE 9
 Lack of comprehensive sexuality education and limited access to
Outcome Interventions
adolescent-friendly reproductive health for high incidence of services
Determining the Effect of
are key reasons teen pregnancies.
Interventions

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