HEALTH EDUCATION PERSPECTIVE
Health
• Old English: “to heal”
• Middle English: “to be sound in body,
mind and spirit”
Health is a highly subjective concept. It’s
meaning varies according to individual
and community expectations and content.
Many people may consider themselves
healthy in the absence of disease, while
people with disability or disease may still
consider themselves healthy if they were
able to manage their conditions, in such a
way that they it does not impact greatly
on their quality of life
• Classic Greek (medicine): “prolong
life and prevent disease”
Hippocratic philosophy: “ Healthy mind
in a healthy Body”
Greeks believed that a person has it
means, it was a punishment from GOD
and they pray in the special healing
temple named Asclepeia to be treated
(Asclepius= Greek God of Medicine)
Another way is animals are being
sacrificed in the temple and the skin of
the animals are being offered to GODs
then, when the patient is asleep and
ready for treatment, snakes will be sliding
across their bodies and touching them
with their tongue
Hippocrates emphasized on
environmental causes and natural
treatments of diseases, the causes and
therapeutic importance of psychological
factors, nutrition and lifestyle,
independence of mind, body and spirit,
and the need for harmony between the
individual and the social and natural
environment
• Ancient India (medicine): “Ayurveda”
• Science of Life
• Holistic Approach to
Healthcare
Similar to Hippocratic Philosophy
Helps people to live a healthy and
balanced life:good health and prevention
and treatment of illness through lifestyle
practices (such as massage, meditation,
yoga, and dietary changes) and the use of
herbal remedies
Ayu= Time from birth to death
Veda=knowledge or learning
• 17th Century (medical books):
“restoration”
• 19th Century: “hygiene”
9th century-health considered colloquial,
replaced with the word hygiene as
considered being more scientific
Health
After World War II, WHO (1948)
“It is a state of complete physical, mental
and social well being and not merely the
absence of disease or infirmity.”
It is a dynamic state.
Health is dynamic and changes from time
to time
Physical health
⚫ Anatomical integrity and
physiological functioning of
the body.
 • Presence of all body
parts
Illness
• all of them are in their
Subjective state of a Person who feels aware
natural place and
of not being well
position
Sickness
• absence of pathology
state of social dysfunction
• proper physiological
function

• working harmoniously Factors in the ecosystem which affect the

optimum level of functioning (OLOF)

Political factors - power and authority to

Mental health
regulate the environment
⚫ Ability to learn and think
Behavioral - habits, their lifestyle, health care
clearly.
and child rearing practices
• able to handle day-to-
Hereditary - congenital defects, strengths, and
day events and
health risks which can be familial, ethnic or
obstacles
racial
• work towards
Health care delivery system - primary health
important goals
care is a partnership approach to the effective
• function effectively in provision of essential health services that are
society community-based, accessible, acceptable,
sustainable and affordable

Environmental influences - the menace of

Social health pollution, communicable diseases due to poor
⚫ Ability to make and maintain sanitation, poor garbage collection, smoking,
acceptable interactions with utilization of pesticides
other people. Socio-economic influence - families in lower
• Empathy income group are the ones mostly Served

• build relationship
with others Education
• connect to positive • It is the communication of
social network information about knowledge, skills
• dealing with conflict and values of the society to each
appropriately succeeding generation to help them
acquire the intellectual and practical
methods to function in society.
Disease Health Education
Existence of some pathology or abnormality Joint Committee (2001)
of the body, which is capable of detection
using, accepted investigation method.
 “any combination of planned learning
experiences based on sound theories that
provide individuals, groups, and communities
the opportunity to acquire information and
the skills needed to make quality health
decisions
Health education is indispensable in
achieving individual and community health.
It can help to increase knowledge and to
reinforce desired behavior patterns. But
there is no single acceptable definition of
health education.
Health education is the part of health care
that is concerned with promoting healthy
behavior.
• WHO (1998)
“Process of providing information and advice
related to healthy lifestyle and encouraging
the development of knowledge, attitudes and
skills aimed at behaviour change of
individuals or communities.”
(WHO) comprises of consciously constructed
opportunities for learning involving some
form of communication designed to improve
health literacy, including improving
knowledge and developing life skills which are
conducive to individual and community
health.
The scope of health education extends
beyond the conventional health sector. It
covers every aspect of family and community
health.
Process that informs, motivates, and help
people to adopt and maintain healthy
practices and life styles.
Purpose of Health Education
Health Education aims to positively influence
the health behaviour and health perspectives
of individuals and communities for them to
develop self-efficacy to adopt healthy
lifestyles resulting to healthy communities.
IMPORTANCE OF HEALTH EDUCATION
1. EMPOWERS people
2. EQUIPS people with knowledge and
competencies to prevent illness, maintain
health
3. ENHANCES the quality of life by promoting
healthy lifestyles.
4. CREATES awareness regarding the
importance of preventive and promotive care.
Legal Basis of Health Education in the
Nursing Curriculum
One of the more important functions of the
nurse is as a health educator and this is
explicitly stated in the Duties of a Nurse in
Rule IV, Sec 28 of the Philippine Nursing Act of
2002 (RA 9173), among which are to:
1. “provide health education to individuals,
families and communities
2. “teach, guide and supervise students in
nursing education;
3. Implement programs including the
administration of nursing services in varied
settings like hospitals and clinics.
Some of the FUNCTIONS of a Professional
Health Educator
1. Assess individual & community needs and
capabilities & identify both internal and
external resources in the community
2. Plan, develop & coordinate with the
different health & government agencies and
NGOs regarding the health education
programs.
3. Do community organizing & outreach ⚫ PRE-HISTORIC ERA
4. Conduct staff training and consult with ⚫ Trial and error
other health care providers about
behavioural, cultural or social barriers to ⚫ Medical lore passed down
health from generation to
generation
5. Conduct regular periodic evaluation of
health education programs ⚫ Throughout history people
have always turned to some
6. Make referrals; type of medicine man or
7. Develop audio, visual, print and electronic physician for counsel
materials to be used for training and conduct Some one may have eaten a particular
of health education classes; plant or herb and become ill. That person
8. Conduct research work and write scholarly would then warn (educate) others against
articles. eating the same substance. Conversely,
someone may have ingested a plant or
herb that produced a desired
Teaching effect. That person would then encourage
 an interactive process that (educate) others to use this substance.
promotes learning
 a system of activities intended to
produce learning ⚫ ANCIENT CULTURES
 mixture of an art and science
⚫ Good hygiene practices

⚫ Code of Hammurabi
Learning
⚫ Before science enabled us to
• involves mental activity by means of determine pathogenic causes
which knowledge, skills, habits, of disease, spiritual
attitudes, ideals, appreciations and explanations and leadership
ideas are acquired, retained and prevailed
utilized resulting in the progressive
The Code of Hammurabi is a well-preserved
adaptation and modification of
Babylonian law code of ancient Mesopotamia,
behaviour
“an eye for an eye”
there should be a change in behaviour,
utilisation or adaptation of learning.
knowledge, attitudes and skills are • MIDDLE AGES
consciously or unconsciously acquired.
• Overcrowding and sanitation
The success of medtech educators endeavour
is measured not by how much content has • Little emphasis on cleanliness
been imparted but rather how much the in early Christianity
person has learned • Disease was caused by sin or
disobeying God

Historical Development of Health Education • Time of great epidemics –

bubonic plague
 Medieval towns and cities are extremely
overcrowded causing lack or poor
sanitation resulted to spread of disease.
Bubonic Plague wiped Europe’s ⅓ of
population (1347-1351)-- BLACK DEATH of
Middle Ages (bubonic plague,
overcrowding, lack/poor of sanitation,
malnutrition and poor hygiene)
• RENAISSANCE
• Beginning of change
• Disease and plague still
rampant
• Bloodletting popular
• “water casting”
• Leeuwenhoek discovered the
microscope
• Hygiene of royalty
• OK to study the human body
and anatomy advanced
First form of transfusion is animal to human
transfusion (usually goat/lamb to human)
Simple light microscope- one lens and used
natural light to view objects
• AGE OF ENLIGHTENMENT
• Disease and plagues still
raged
• Miasmas theory of disease
took hold
The miasma theory (also called the miasmatic
theory) held that diseases such as cholera,
chlamydia, or the Black Death were caused by
a miasma (μίασμα, ancient Greek:
"pollution"), a noxious form of "bad air", also
known as night air.
It supposedly could be recognized by its smell
of decomposition. The miasma theory states
that diseases and sicknesses come from
breathing in a miasma. The miasma cloud
would infect you with a sickness and you
would die. People thought these miasmas
occurred in only filthy places or off things that
smelled bad like rotten food or sewage.
Edward Jenner discovered vaccine procedure
for smallpox
Innovative contribution to immunization and
eradication of smallpox
Done by INOCULATION ( subcutaneous
instillation of smallpox virus into nonimmune
individuals)
The inoculator usually used a lancet wet with
fresh matter taken from a ripe pustule of
some person who suffered from smallpox. The
material was then subcutaneously introduced
on the arms or legs of the nonimmune person
• 1800’s (Bacterial period of public
Health)
• 1842 Edwin Chadwick’s report
• Louis Pasteur – Germ theory
of disease
• Joseph Lister – antiseptic
method
Chadwick’s report on Sanitary condition.
Edwin Chadwick is most associated with
public health improvements during the
era of Queen Victoria.
Edwin Chadwick was commissioned by
the government to undertake an
investigation into sanitation and make
recommendations on improving
conditions. Chadwick found that there
was a link between poor living standards
and the spread and growth of disease. He
recommended that the government
should intervene by providing clean
water, improving drainage systems and
enabling local councils to clear away
refuse from homes and streets.
 The germ theory of disease states that • Report of Joint Committee on
many diseases are caused by Health Education &
microorganisms. These small organisms, Promotion Terminology
too small to see without magnification,
• Outcome-Based Education &
invade humans, animals, and other living
Practice
hosts. Their growth and reproduction
within their hosts can cause a disease. • Patient Protection &
Affordable Care Act (expands
Lister is now known as the 'father of
health care coverage)
antiseptic surgery'. search for a way of
preventing infection CUP=6 yr project to reverify the entry-level
health education responsibilities,
competencies and subcompetencies and to
• 1970’s: The Era of Prevention verify the advanced-level competencies and
subcompetencies
• CDC was established
Identifies Three Levels of practice:
• Healthy People: The Surgeon
General’s Report on Health a. Entry- performed by health educators
Promotion and Disease with BS and MS and less than 5 yrs of
Prevention was published experience

• 1980’s b. advanced 1- BS and MS with more

than 5 yrs of experience
• Initial Role Delineation study
for Health Education c. advanced 2- Health educators with
PHD and 5 or more years of
• First Certified Health
experience
Education Specialists (CHES)
recognized

ROLE of the HEALTH EDUCATOR

CDC = Center for Disease Control and • The HEALTH EDUCATOR’S ROLE is to
Prevention. Concerned with occupational help promote, enhance, and maintain
safety and health the health of others.

major operating components of the • The primary role of Health Educators

Department of Health and Human Service in
USA
Standards and guidelines primarily related to
infection control and safe work practices
is to develop appropriate health
education programs in consultation
with the people they serve through:
• a) Planning

• b) Implementing

• 1990’S • c) Evaluating the health

plans/programs
• Competencies Update Project
(CUP)

• 2000’S Evolution of the Teaching Role of Nurses

• Unified Code of Ethics

  Teaching as function within the scope
of nursing practice
 Educating their colleagues
 Training the trainer
SEVEN AREAS OF RESPONSIBILITY
Seven Areas of Responsibility for Health
Education Specialist - the broad entry-level
skills necessary for the practice of health
education in all settings.
I: Assess needs, assets and capacity for health
education
II: Plan health education
III: Implement health education
IV: Conduct evaluation and research related
to health education
V: Administer and manage health education
VI: Serve as a health education resource
person
VII: Communicate and advocate for health
and health education
Dimensions Of Teaching-Learning Process
• Teaching objectives & Learning Needs
• Teaching-Learning Process
• Instructional Content
• Teaching Strategies
• External Conditions
• Inter-Intra personal relationships
• Outcome of Health Education Process
Teaching objectives & Learning Needs
What do the students need to know?
• setting and communicating
lesson
goals
- must provide challenge
- explain the connections between
learning goals, learning activities and
assessment tasks
GOAL SETTING
Specific
Measurable
Achievable
Realistic
Timely
To let student understand the success criteria,
commit to learning, and provide the
appropriate mix of success and challenge
Teaching-Learning Process
deliver structured lessons which incorporate
a series of clear steps and transitions between
them, scaffold learning to build students’
knowledge and skills
Involves the teacher and student behavior
begin with overviews and/or review
objectives call attention to main ideas Use
explicit teaching to provide instruction,
demonstrate concepts teachers show what to
do and how to do it create opportunities in
lessons for students to demonstrate
understanding and apply the learning
Education Process
It is a systematic, sequential, planned course
of action consisting of two major
interdependent operations, teaching and
learning This process forms a continuous cycle
that also involves two interdependent players,
the teacher and the learnor. jointly perform
teaching and learning activities, the outcome
clear
of which leads to mutually desired behavior
changes.
Teaching/ Instruction
Teaching is a deliberate intervention that
involves the planning and implementation of
instructional activities and experiences to
meet intended learner outcomes according to
a teaching plan. Instruction is a component of
teaching that involves the communicating of
information about a specific skill in the
cognitive, psychomotor, or affective domain.
Difference of Nursing Process and Education
Process
NURSING PROCESS
 Appraise physical and psychosocial
needs Develop care plan based on
mutual goal setting to meet individual
needs.
 Carry out nursing care interventions
 using standard procedures
 Determine physical and psychosocial
outcomes
ASSESSMENT
PLANNING
IMPLEMENTATION
EVALUATION
EDUCATION PROCES3
 Ascertain learning needs, readiness to
learn and learning styles
 Develop teaching plan based on
mutually predetermined behavioral
outcomes to meet individual needs
 Perform the act of teaching using
specific teaching methods and
instructional materials
 Determine behavioral changes
(outcomes) in knowledge, attitudes,
and skills
ASSURE MODEL
The Assure model is a paradigm to assist
nurses to carry out and organize and
Education Process
 Evaluate/revise the teaching and
learning process.
 Requires learner performance.
 Use Teaching materials
 Select instructional materials and
tools
 State the objectives
 Analyze the learner
HOW SHOULD EDUCATION BE CONDUCTED?
 Demonstration - most useful method
where the process of doing a
procedure is shown and the skills or
techniques are practiced through
return demonstration
 Word of mouth - is the most
influential way of transmitting
especially of oral traditions which are
usually conveyed by means of
puppets or puppet shows,
dramatization, or sociodrama, role-
playing, storytelling, music and songs
 Use of audio -visual aids - leaflets,
charts, posters, flashcards, flip charts
and flannel graphs
 Film - showing - the use of modular
instruction is also an effective
medium of instruction where the
learner uses his/her senses of sight,
hearing, touching, smelling and even
tasting
 inter= learning behavior involved in
interacting with others
Instructional Content
intra= learners try to understand their inner
Should Contain:
feelings, dreams, relationships with others
-visuals that establishes the purpose of the and strengths and weaknesses; evaluating
lesson thinking patterns, reasoning with themselves

-organization of the lesson

- Modeling to the teacher’s performance Outcome Of Health Education Process

expectations
• COGNITION CHANGE

• knowledge or perception of a
Teaching Strategies person

The relationship between what is taught and • ATTITUDE CHANGE

how it is taught is critical in order to maximise
• beliefs, predisposition,
student learning.
intentions and tendencies
Example of teaching strategies
• BEHAVIOR CHANGE
1. Direct teaching - highly structured and
• individual / group’s
explicit teaching - Drill, practices
knowledge, attitude and
2. interactive teaching - supports practice
students in working collaboratively
Brain function determines our personality,
and productively in active, hands-on
emotions, and intellect (cognition)— the
and participatory learning - whole-
attributes that make us unique. Cognitive
class discussion
abilities are the mental skills you need to carry
3. indirect - learner-centered and gives out any task.
students opportunities to make
• Attitude is the driving force in our
decisions and choices about their
lives, and can either push us to
learning - problem-based learning
greatness, or to our demise.
4. experiential learning - enables student
• Behavior change can refer to any
to learn and construct meaning
transformation or modification of
through experiences - field
human behavior. It may also refer to:
experience, simulation
Behavior change (public health), a
broad range of activities and
approaches which focus on the
External Conditions individual, community, and
Technology, facilities, time, learning environmental influences on
environment behavior.

Inter-Intra personal relationships PROCESSES THAT DETERMINE THE EXTENT

TO WHICH A PERSON MAY BE PERSUADED
Three major relationship influence in students TO CHANGE
are parents/ guardians, teachers and peers
 • Attention
• Comprehension
• Acceptance
• Retention
• BARRIERS TO CHANGE
• Cultural barriers
• Social barriers
• Psychological barriers
• Language difficulties
Beliefs and values differ from person to
person so it is hard to categorize what is and
is not a cultural norm within a grouptraditions
and values conflicting with the innovation
Social Barriers to Change: group psychology
factors inhibiting implementation. Group
solidarity. Rejection of outsiders, Conformity
to norms, Conflict
Psychological Barriers to Change: individual
traits and reactions discouraging adoption.
Perception, Homeostasis, Conformity and
commitment, Personality factors
• BARRIERS TO TEACHING
• Lack of Time to teach
• Lack of competence or
confidence with teaching
skills
• Lack of motivation
• Low priority to patient and
staff education
• Environment – conducive
• OBSTACLE TO LEARNING
• Lack of Time – rapid
discharge+ amount of
information
• Presence of illness
• Low literacy
• Hospital Environment
• Personal Characteristics of the
learner
• OBSTACLE TO LEARNING
• Extent of behavioral changes
• Lack of support
• Denial of learning needs
• Inconvenience in healthcare
facilities
Characteristics of Effective Health Education
• It is directed at people who have influence
in the community who are also the opinion
makers
• The lessons are repeated and reinforced
over time using different methods
• The lessons are adaptable and use existing
channels of communication like songs, drama
and story telling
• It is entertaining and attracts the
community's attention
• Uses clear, simple language with local
expressions
• It emphasizes short term benefits of action
• It provides opportunities for dialogue,
discussion, and learner participation
• It uses demonstrations to show the benefits
of adopting the practices
The Nurse as an Educator
• Should possess the necessary attitude and
competencies to effectively create a
productive atmosphere related to the
teaching-learning process (Alegado, 1996)
• Good teachers know how to help people
become conscious of their own values, to
examine these values and to build for
themselves those values that are more
satisfying to society
5 Levels of Competency in Nursing Practice
PATRICIA BENNER'S MODEL
• Novice - no exposure; task/skilled
focused; rule follower
 Advanced Beginner - has some
experience; past experience guides
action
 Competent - 2-3 years experience;
good time management; planning;
thinks analytically
• Proficient - holistic understanding;
uses experiences to anticipate needs
 Expert - flexible; intuitive; lots of
experiences; just comes naturally
Teaching of Health Education related to
critical health issues:
1. Emotional health and a positive self-image;
2. Appreciation and care of the human body
and its vital organs;
3. Physical fitness;
4. Health issues of alcohol, tobacco, drug use
and abuse;
5. Health misconceptions and myths;
6. Effects of exercise on the body systems and
on general well-being;
7. Nutrition & weight control
8. Sexual relationships & sexuality
9. The scientific, social, and economic aspects
of community and ecological health;
10. Communicable and degenerative diseases
including STI;
11. Disaster preparedness;
12. Safety & driver education;
13. Environmental factors and how those
factors affect an individual’s or
population’s Environmental health
(ex: air quality, water quality, food
sanitation); life skills; choosing
professional medical and health
services; and choices of health
careers.
Theories of Health Education
a. Health Belief Model
• The model is based on the theory that
a person's willingness to change their
health behaviors primarily comes
from their health perceptions.
• According to this model, your
individual beliefs about health and
health conditions play a role in
determining your health-related
behaviors.
Components of the Health Belief Model
1. Perceived Severity
The probability that a person will change
their health behaviors to avoid a
consequence, depends on how serious
they believe the consequences will be.
2. Perceived Susceptibility
People will not change their health
behaviors unless they believe that they
are at risk.
3. Perceived Benefits
It refers to the perceived effectiveness of
taking action to improve a health
condition. It's difficult to convince
people to change a behavior if there isn't
something in it for them. People don't
want to give up something they enjoy if
they don't also get something in return
4. Perceived Barriers
It refers to the perceived impediments to
taking action to improve a health
condition.
One of the major reasons people don't
change their health behaviors is that they
think doing so is going to be hard.
Changing health behaviors can require
effort, money, and time.
5. Cues to Action
It refers to the inducement necessary to
generate the decision-making process to
admit a recommended health action.
One of the best things about the Health
Belief Model is how realistically it frames
people's behaviors. It recognizes the fact
that sometimes wanting to change a
health behavior isn't enough to actually
make someone do it
6. Self-Efficacy
Self-efficacy refers to the self- confidence
in one’s ability to take action.
Self-efficacy wasn't added to the model
until 1988. Self-efficacy looks at a person's
belief in their ability to make a health-
related change. It may seem trivial, but
faith in your ability to do something has
an enormous impact on your actual ability
to do it.
B. Social Cognitive Theory (SCT):
Social Cognitive Theory, developed by
Albert Bandura, highlights the reciprocal
interaction between personal factors,
behavior, and the environment.
It is a theory of learning process and social
behavior which proposes that new
behaviors can be acquired by observing
and imitating others.
SCT emphasizes observational learning,
self-efficacy (belief in one's ability to
perform a behavior), and outcome
expectations (anticipated consequences
of behavior) in shaping health behaviors.
C. Theory of Planned Behavior (TPB):
The Theory of Planned Behavior posits
that behavioral intentions are influenced
by attitudes toward the behavior,
subjective norms (perceived social
pressure to perform or not perform the
behavior), and perceived behavioral
control (belief in one's ability to perform
the behavior).
TPB emphasizes the importance of
attitudes, subjective norms, and perceived
control in predicting and understanding
health behaviors.
D. Transtheoretical Model (TTM) or Stages of
Change Model:
The Transtheoretical Model proposes that
behavior change occurs through a series of
stages: precontemplation, contemplation,
preparation, action, maintenance, and
termination.
It emphasizes that individuals move through
these stages cyclically and may require
different interventions at each stage to
facilitate behavior change.
E. Ecological Model:
The Ecological Model, also known as the
Socio-Ecological Model, considers the
complex interplay between individual, It emphasizes the importance of perceived
interpersonal, community, and societal self-efficacy, perceived barriers, and
factors that influence health behaviors. perceived benefits in predicting and
explaining health behaviors.
It emphasizes the importance of addressing
multiple levels of influence and creating
supportive environments for behavior change.

F. Diffusion of Innovations Theory:

Diffusion of Innovations Theory explains how
new ideas, products, or behaviors spread
within a population over time.
It identifies different adopter categories
(innovators, early adopters, early majority,
late majority, laggards) and factors influencing
the adoption process, such as relative
advantage, compatibility, complexity,
trialability, and observability.
These theories provide valuable frameworks
for understanding the determinants of health
behaviors, designing effective interventions,
and promoting positive health outcomes
across diverse populations and contexts.
Health educators often draw upon multiple
theories and models to tailor interventions to
the unique needs and characteristics of their
target audiences.

G. Behaviorist Learning Theory:

It states that behaviors are learned from the

environment and says that innate or inherited
factors have very little influence on behavior.

Teachers can implement behavioral learning

strategy techniques including: Drills, Question
and answer, Guided practice, Regular review,
Positive reinforcement (most common).

It also helps teachers understand that a

student’s home environment and lifestyle can
be impacting their behavior, helping them see
it objectively and work to assist with
improvement.

H. Health Promotion Model:

The Health Promotion Model focuses on

promoting health and preventing illness by
addressing individual characteristics and
experiences, behavior-specific cognitions and
affect, and behavioral outcomes.