1. Health Education in the Community

2. Theoretical Bases
Theories describe, explain, and predict behaviors within a functional framework
Theories about health education and behavior change help nurses understand behavior and develop useful strategies that influence people’s health

3. Theoretical Bases: Concepts
Advocacy
Barriers
Benefits
Cognitive dissonance
Empowerment
Motivation
Readiness
Self-efficacy

4. Theoretical Bases: Learning Theory
Assumptions of adult learning theory:
Adults perceive themselves to be self-directed: They want to have a say in what they learn
Adults have a variety of life experiences and are insulted if these experiences are ignored: The wise teacher will build on these experiences

5. Theoretical Bases: Learning Theory
Assumptions of adult learning theory:
Adults learn better when they see an immediate need: They are goal directed
Timing education to coincide with an immediate need is more effective because the learner will see the immediate goal and be ready to learn

6. Theoretical Bases: Behavior Change Theory
Health belief model
Harm reduction model
Goal-setting theory
Theory of reasoned action
Social learning theory
Diffusion theory
Social marketing theory

7. Transtheoretical Model
Precontemplative
Contemplative
Preparation
Action
Maintenance
Relapse

8. Processes to Enhance Progression Through Stages
Consciousness raising
Dramatic relief
Environmental reevaluation
Self-reevaluation
Self-liberation
Helping relationships
Social liberation
Counter conditioning
Stimulus control
Reinforcement management

9. The Health Education Process
Health education is a process of planned teaching and support activities that help people learn
The education process follows the format of the nursing process (assessment, planning, implementation, and evaluation)

10. Assessment: What to Assess
Client understanding of the problem in question
Client perception of need to change
Motivation to change: severity of problem and risks caused by the problem
Readiness to change

11. Assessment: What to Assess
Self-efficacy
Perceived benefits to change
Perceived barriers to change
Psychosocial issues
Learning skills

12. Planning
The nurse and client discuss learning needs and goals and then negotiate to produce a list of learning objectives
The goals and objectives provide direction for implementation and guide evaluation
Objectives are specific and measurable
Objectives address different domains of learning

13. Domains of Learning
Cognitive
Psychomotor
Affective

14. Implementation
Design teaching based on assessments of individual clients
Develop educational objectives with input from the learner
Create a learning environment
Keep things simple

15. Implementation Focus on one issue at a time
Be sure written materials are appropriate
Be specific
Avoid threatening messages that generate fear
Explain what you will be teaching and why it is important

16. Implementation Provide for success Use a variety of teaching methods
Provide visual learning materials
Show the client what is expected
Skills require practice
Involve all senses in practice sessions

17. Implementation Develop mechanisms for support
Discuss resources for further information
Review major points of each learning session
Keep learners involved: Ask for feedback and evaluation

18. Evaluation
Evaluation is a process of gathering information to assess the extent to which learning objectives have been met or not met
All evaluation methods should be based on the learning objectives
Summative evaluation
Formative evaluation

19. Health Education in Communities
Individuals, families, & groups
Discharge teaching
Community-based teaching

20. Advantages to Teaching in Client’s Home
Nurse can assess the client’s environment and make changes to the teaching plan to compensate for problems and to take advantage of strengths
The family can be more easily involved

21. Advantages to Teaching in Client’s Home
The client will usually be more comfortable in his or her own environment
The client will be learning in the environment in which he or she will be using new information to perform new skills and behaviors

22. Community
Health education at the community level begins with community assessment
Planning requires community involvement
Encourage an implementation process that helps a community meet its own needs
Effective evaluation determines progress toward goals and identifies goals not met

23. Community Data from evaluation are used to:
Determine if unmet goals are still a priority
Plan interventions to address unmet goals
Assess the impact of goals that have been achieved
Assess evolving needs
Establish new community goals and objectives

24. Ethical Issues in Health Education
Manipulation of behavior versus information dissemination
Obligation of nurses to keep up with advances in health care
Social and economic barriers related to growing gap between classes
Community and cultural norms