1. 1 Health Education Practice Settings (Excerpted from Chapter 15 of “Introduction to Health Education and Health Promotion” by Bruce G. Simons-Morton, Water H. Greene, and Nell H. Gottlieb, Waveland Press, Inc. 1995)

2. 2 Introduction Health education occurs in a variety of places, these include: Schools Worksites Health care organizations Health departments Voluntary health agencies Community settings

3. 3 Comparison of Settings SettingPrimary MissionWho is Served? SchoolEducationChildren/adolescents WorksiteProduce goods and services; Make a profit (if applicable) Consumers of products and services HospitalsTreat illness and traumaPatients Community primary care setting Prevent, detect, and treat illness and trauma Patients Health DepartmentChronic and infectious disease prevention and control Public Voluntary health agenciesPrevention and control targeted disease/condition Public

4. 4 Objectives for Educational and Community-Based Programs by Settings SettingObjectives SchoolIncrease to at least 75% the proportion of the nation's elementary and secondary schools that provide planned and sequential kindergarten through twelfth-grade quality school health education. WorksiteIncrease to at least 50% the proportion of postsecondary institutions with institution-wide health promotion programs for students, faculty and staff. Health care providerIncrease to at least 90% the proportion of hospitals, and health maintenance organizations, that provide patient education programs, and to at least 90% the proportion of community hospitals that offer community health promotion programs addressing the priority health needs of their communities. CommunityIncrease to at least 50% the proportion of counties that have established culturally and linguistically appropriate community health promotion programs for racial and ethnic minority populations.

5. 5 School Health Education Themes 1. Education and health are interrelated. 2. The biggest threats to health are “social morbidities.” 3. A more comprehensive, integrated approach is needed. 4. Health promotion and education efforts should be centered in and around school. 5. Prevention efforts are cost-effective; the social and economic costs of inaction are too high and still escalating.

6. 6 Quality Classroom Instruction Goals Students embrace health as a value Students be provided with the knowledge, skills, and empowerment needed to choose and maintain healthful personal behaviors As a lifetime learner, students be able to obtain, evaluate, and use new information for future health-related decisions.

7. 7 Comprehensive School Health Program

8. 8 Health Education A planned, sequential, K-12 curriculum that addresses the physical, mental, emotional and social dimensions of health. The curriculum is designed to motivate and assist students to maintain and improve their health, prevent disease, and reduce health-related risk behaviors. It allows students to develop and demonstrate increasingly sophisticated health-related knowledge, attitudes, skills, and practices. The comprehensive health education curriculum includes a variety of topics.comprehensive health education curriculum

9. 9 Physical Education A planned, sequential K-12 curriculum that provides cognitive content and learning experiences in a variety of activity areas. Quality physical education should promote, through a variety of planned physical activities, each student's optimum physical, mental, emotional, and social development, and should promote activities and sports that all students enjoy and can pursue throughout their lives.

10. 10 Health Services Services provided for students to appraise, protect, and promote health. Qualified professionals such as physicians, nurses, dentists, health educators, and other allied health personnel provide these services.

11. 11 Nutrition Services Access to a variety of nutritious and appealing meals that accommodate the health and nutrition needs of all students. The school nutrition services offer students a learning laboratory for classroom nutrition and health education, and serve as a resource for linkages with nutrition-related community services.

12. 12 Counseling and Psychological Services Services provided to improve students' mental, emotional, and social health. These services include individual and group assessments, interventions, and referrals. Organizational assessment and consultation skills of counselors and psychologists contribute not only to the health of students but also to the health of the school environment.

13. 13 Healthy School Environment The physical and aesthetic surroundings and the psychosocial climate and culture of the school. The psychological environment includes the physical, emotional, and social conditions that affect the well-being of students and staff.

14. 14 Health Promotion for Staff Opportunities for school staff to improve their health status through activities such as health assessments, health education and health- related fitness activities. This personal commitment often transfers into greater commitment to the health of students and creates positive role modeling. Health promotion activities have improved productivity, decreased absenteeism, and reduced health insurance costs.

15. 15 Family/Community Involvement An integrated school, parent, and community approach for enhancing the health and well-being of students. School health advisory councils, coalitions, and broadly based constituencies for school health can build support for school health program efforts. Schools actively solicit parent involvement and engage community resources and services to respond more effectively to the health-related needs of students.

16. 16 Worksite Health Education Programs Physical activity and fitness Nutrition and weight control Stress reduction Worker safety and health Blood pressure and/or cholesterol education and control Alcohol, smoking and drugs

17. 17 Motivations for Employers Reduces medical care costs Enhances productivity Enhances the image of the company

18. 18 An Example of a Worksite Health Education Program - Nutrition LevelProgram Strategy IndividualNutrition information available through newsletters, books and video; Nutrition behavior-change program. InterpersonalHealthful food cooking contests; Nutrition classes for families; Buddy programs for weight loss; Competitions for weight loss. OrganizationalCafeteria offers low-fat and low-calorie choices; Labeling of nutritional content of foods in cafeteria; Subsidized healthful foods; Vending machines with healthful foods. CommunityInstitutional food service vendors offer low-fat and low-calorie foods; Nearby restaurants offer low-fat and low-calorie foods; A community campaign focuses on good nutrition.

19. 19 Health Care Settings In the hospital, direct patient education is part of ongoing patient care and is typically delivered by nurses and physicians Group health education on such topics as diabetes and prenatal care are also provided

20. 20 An Example of Health Education in Health Care Settings – Cystic Fibrosis (CF) LevelStrategies IndividualEducational modules including feature stories, information about the disease process, skills, and self- monitoring. InterpersonalInteraction with health care team members about patient concerns related to CF and goals for self- management; Family discussion and practice of self- management behaviors and symptom monitoring. OrganizationalPrimary care physician refers family to program; CF Family Education Program provided by CF Center CommunitySchool nurses and teachers assist child and family in self-management of CF

21. 21 Federal Community Health Settings Public tax-supported health agencies Department of Health and Human Services The National Institutes of Health The Centers for Disease Control and Prevention The Food and Drug Administration The Indian Health Service The Alcohol, Drug Abuse and Mental Health Administration The Health Care Finance Administration

22. 22 Local and State Health Departments Direct health services are offered by the local health departments. Planning, Consultation, vital statistics, laboratory services, regulation, and coordination functions occur at the state as well as the local levels. Health educators work in family planning, nutrition, dental health, tobacco control, chronic disease, AIDS, immunizations, and communicable diseases,

23. 23 Example of Local and State Health Department Health Education Strategies LevelProgram Strategy IndividualMass media campaigns to increase knowledge of the risks of breast cancer, the benefits of screening, and how to obtain screening services. InterpersonalUse of community volunteers to alert women to the importance of breast cancer screening and how to obtain information; Encourage discussion of breast cancer screening and benefits through small group educational programs and through feature stores in media. OrganizationalProvider referral of women already enrolled in health department programs; Outreach activities directed to worksites, senior centers and churches to alert women about the program. CommunityCreate coalitions of providers to offer coordinated screening, referral, diagnostic, and treatment services.