Transcript Psychological Basis of Health Education (CHS 384)

Psychological Basis of Health
Education
(CHS 384)
INSTRUCTOR: NORAH ALSADHAN, MPH
Lecture-1September/15/2013
The Scope of Health Education
and Health Behavior
Health education and health promotion are recognized
increasingly as ways to meet public health objectives
and improve the success of public health and
medical interventions around the world.
Health educators work in a variety of settings including
schools, worksites, governmental organizations,
medical settings, communities,…etc
The Scope of Health Education
and Health Behavior
• The art of health behavior and health education is rapidly
evolving.
• The most frequent causes of death globally are chronic diseases
including heart disease, cancer, lung disease, and diabetes.
• Recently there has been a dramatic increase in public, private,
and professional interest in preventing disability and death
through changes in lifestyle and participation in screening
programs. This interest is stimulated by the epidemiological
transition from infectious to chronic disease, the aging of the
population, and the rapidly escalating health care costs.
Definitions of Health
Education
• “Health education is concerned not only with
individuals and their families, but also with the
institutions and social conditions that impede or
facilitate individuals toward achieving optimum
health” William Griffiths(1972)
• “Health education attempts to close the gap between
what is known about optimum health practice and
that which is actually practiced”
Definitions of Health
Education
• “Health Education is aimed at bringing about
behavioral changes in individuals, groups , and
larger populations from behaviors that are presumed
to be detrimental to health, to behaviors that are
conducive to present and future health”. Simonds
(1976)
• “Any combination of learning experiences designed
to facilitate voluntary adaptation of behavior
conducive to health” Green (1980)
Definitions of Health
Education
• Health education includes not only instructional activities
and other strategies to change individual health behavior
but also organizational efforts, policy directives, economic
supports, environmental activities, mass media, and
community-level programs.
• Health Education covers the continuum from disease
prevention and promotion of optimal health to the
detection of illness to treatment, rehabilitation, and longterm care
Any other ideas on
?
Health Promotion
Health Promotion is define as “ any combination of
health education and related organizational,
economic, and environmental supports for behavior
of individuals, groups, or communities conducive to
health” (Green and Kreuter, 1991)
Definitions of Health
Behavior
• The central concern of health education is health behavior.
• Health behavior refers to “the actions of individuals, groups , and
organizations, as well as their determinants, correlates, and
consequences, including social change, policy development and
implementation, improved coping skills, and enhanced quality of
life. (Pakerson and others,1993)
• “Those personal attributes such as beliefs, expectations, motives,
values, perceptions, and other cognitive elements; personality
characteristics, including affective and emotional states and traits;
and overt behavior patterns, actions, and habits that relate to
health maintenance, to health restoration, and to health
improvements” (Gochman, 1982,1997)
Categories of health Behavior
• Preventive health behavior: any activity undertaken by an
individual who believes himself or (herself) to be healthy, for
the purpose of preventing or detecting illness in an
asymptomatic state.
• Illness behavior: any activity undertaken by an individual who
perceives himself to be ill, to define the state of health, and to
discover a suitable remedy
• Sick-role behavior: any activity undertaken by an individual
who considers himself to be ill, for the purpose of getting well.
It includes receiving treatment from medical providers, generally
involves a whole range of dependent behavior and leads to some
degree of exemption from one’s usual responsibilities.
Using theory in crafting interventions can lead to more
powerful effects than interventions developed
without theory.
Theory and Practice
• Theory and practice are a continuum along which the skilled
professional should move with ease.
• The best theory is informed by practice and the best practice should be
grounded in theory.
• Theory and practice build on each other.
• The task of health behavior and health education is both to
understand health behavior and to transform knowledge about
behavior into effective strategies for health enhancement.
• Health educators usually work in situations where sources are
limited, thus, it is essential that they reach evidence-informed
judgments about the interventions.
Theory
• Is a set of interrelated concepts, definitions, and
propositions that present a systematic view of events or
situations by specifying relations among variables, in order
to explain and predict the event or situation.
• Theories explain behavior and suggest ways to achieve
behavior change
• A theory must have these qualities:
• Generalizability
• Testability
• Abstract: no specified content or topic area.
Theory
Theories guide the search for Why? What? How?
Concepts
• Major components of a theory
• Building blocks
Constructs
• A concept that has been developed or adopted for
use in a particular theory.
• A construct can only be understood in the context of
its parent theory
• A construct must be measurable in order to qualify
as a construct
• Example: self-efficacy
Variables
• The empirical counterparts of constructs
• They specify how a construct is to be measured in a
specific situation
• Example: creating a questionnaire to measure
depression so you can assign a score to an
individual.
How do variables affect each
other
• Correlative:
• Depression and cancer
• Causative:
• Smoking and heart disease
• Coincident:
• Being left-handed and developing diabetes.
How do variables affect each
other
Mediating:
• A process that intervene between input and output in a system
• Example: social support mediates between stress and disease
Moderating:
• A variable that affects the direction or strength of the relation
between the independent and dependent variable
• Example: lifestyle factors moderate the effect of race on
hypertension.
Types of theory
Explanatory theories:
• Describe problems
• Identify source of problems
• Search for modifiable factors
• Examples:
• Health belief Model
• Theory of planned behavior
Types of theory
Change theories
• Intervention design
• Evaluation strategies
• Provide explicit assumption for why a program will work
• Help determine why a program didn’t work
• Examples:
• Community organization
• Diffusion of innovations
Model
• Most health behavior is too complex to be explained
by a single theory
• Models are constructed from theories and empirical
findings
• PRECEDE-PROCEED
• Social Marketing
• Ecological planning model
Applying theory
• Begins with identifying a problem
• Population affected
• Units of analysis or change
• Types of behavior to be addressed
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One time intervention( mammography)
Lifestyle Change (regular exercise)
Cessation (smoking)
Adoption (flossing)