Overview of Health
Education and Promotion
Principles and Theories
Community and Public Health for Medical
Laboratory Science (CPHM 121)
College of Medical Laboratory Science
Our Lady of Fatima University
D EFINITIONS
Introduction: Health Education
– Health education should be viewed within the
changing context of health and disease; within the
changing health picture where lifestyles play an
important role and within the accepted definition
of health.
Health Education
- “Educe” Latin for “to lead out”
- Leading out what people already “know” and
“believe” and do about their health; modifying
those that are undesirable, and developing
desirable behaviors that are conducive to
health
Health Education
Any combination of learning experiences
designed to facilitate voluntary adoption of
behavior conducive to health
– Green et al, 1980
Health Education
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
• Health Promotion Glossary, WHO, 1998
HEALTH LITERACY
Capacity of an individual to obtain, interpret,
and understand basic health information and
services and the competence to use such
information and services in ways that are
health enhancing
• Joint Committee on Health Education and
Promotion Technology (Sharma & Romas,2008)
HEALTH LITERACY: Domains
(Zarcadoolas, Pleasant, and Green, 2003)
1. Fundamental literacy/numeracy
2. Science and Technology
3. Community/civic literacy
4. Cultural literacy
HEALTH LITERACY: Domains
(Zarcadoolas, Pleasant, and Green, 2003)
1. Fundamental literacy/numeracy
– Competence in understanding and using
printed language, spoken language,
numerals, and basic mathematical
symbols or terms
– Involved in a wide range of cognitive,
behavioral, and social skills and abilities
HEALTH LITERACY: Domains
(Zarcadoolas, Pleasant, and Green, 2003)
2. Literacy pertaining to science
and technology
– Understanding of the basic
scientific and technological
concepts, technical complexity,
the phenomenon of scientific
uncertainty, and the
phenomenon of rapid change
HEALTH LITERACY: Domains
(Zarcadoolas, Pleasant, and Green, 2003)
3. Community/civic literacy
• Understanding about sources of
information, agenda, and methods
of interpreting those agenda
• Enables people to engage in dialog
and decision making; includes
media interpretation skills and
understanding of civic and
legislative functions
HEALTH LITERACY: Domains
(Zarcadoolas, Pleasant, and Green, 2003)
4. Cultural literacy
– Understanding of collective
beliefs, customs,
worldviews, and social
identify relationships to
interpret and produce
health information
Health Promotion
Any planned combination of educational,
political, regulatory and organizational
supports for actions and conditions of living
conducive to the health of individuals, groups
or communities
– Green and Kreuter, 2005
Health Promotion
Process of enabling people to increase control
over the determinants of health and thereby
improve their health
– World Health Organization, 1998
F
OUNDATIONS
Health Promotion and Education:
Foundations
beacon light, guide, direction what or content
Philosophical Biomedical
Psycho-social
how or the methods
Predominant Philosophies
❖Behavior change philosophy
❖Cognitive-based philosophy
❖Decision-making philosophy
❖Freeing/functioning philosophy
❖Social change philosophy
Biomedical Foundation
❖Microbiology
❖Parasitology
❖Nutrition
❖Environmental Health
❖Occupational Health
Psycho-social Foundation
❖Psychology
❖Anthropology
❖Sociology
❖Political Science
Building Blocks for
Promoting Health (Moodie, 2004)
System for intelligence gathering
Clear policy, legislation, and regulation
Communication of information
Provision of primary services
Sharing of responsibility across sectors
Mobilization of communities
E
VENTS THAT SHAPED HEALTH PROMOTION
Conferences on Health Promotion
Ottawa Charter on Adelaide Healthy Sundsvall Sustainable
Health Promotion, 1986 Public Policy, 1988 Environment, 1991
Jakarta Declaration, 1997 Mexico Ministerial Statement Bangkok Charter for Health
for the Promotion of Health, 1999 Promotion in a
Globalized World, 2005
Nairobi Call to Action, 2009
A
CTION AREAS FOR HEALTH PROMOTION
1. DEVELOP HEALTHY PUBLIC POLICY
Healthy public policy is characterized by an explicit
concern for health and equity in all areas of policy,
and by an accountability for health impact
2. CREATE SUPPORTIVE ENVIRONMENTS
Supportive environments for health offer people protection
from threats to health, and enable people to expand their
capabilities and develop self-reliance in health
Encompass where people live, their local community, their
home, where they work and play, including access to
resources for health, and opportunities for empowerment
3. STRENGTHEN COMMUNITY ACTION
Community action for health refers to collective efforts
by communities which are directed towards increasing
control over the determinants of health.
Individuals and organizations apply their skills and
resources in collective efforts to address health
priorities and meet their respective health needs.
4. DEVELOP PERSONAL SKILLS
Life skills are fundamental building blocks
for the development of personal skills
Consist of personal, interpersonal,
cognitive and physical skills
Examples: decision making and problem
solving, coping with emotions and
managing stress, communication skills and
interpersonal relationship skills
5. REORIENT HEALTH SERVICES
Characterized by a more explicit concern for the
achievement of population health outcomes in the ways
in which the health system is organized and funded
Reorientation must lead to a change of attitude and
organization of health services, which focuses on the
needs of the individual as a whole person, balanced
against the needs of population groups
STRATEGIES/METHODS IN HEALTH
EDUCATION/PROMOTION
CLASSIFICATION OF HEALTH PROMOTION
STRATEGIES/METHODS:
A. According to focus
B. Use of Behavioral theories
C. According to target factors
STRATEGIES/METHODS IN HEALTH EDUCATION/
PROMOTION
CLASSIFICATION OF HEALTH PROMOTION STRATEGIES/METHODS:
A. According to focus
➢ Focus on the individual
➢ The origin of health education/promotion
➢ Usually utilized for purposes of secondary and tertiary prevention
➢ Focus on groups
➢ Utilized for a number of persons present in one setting at the same time
➢ Appropriate for the purposes of primary, secondary, and tertiary
prevention programs
➢ Focus on whole population
➢ Most of the time utilize mass media to maximize coverage of the target
populations
➢ Very cost – effective for the purposes of empowerment and for primary
prevention
STRATEGIES/METHODS IN HEALTH EDUCATION/
PROMOTION
CLASSIFICATION OF HEALTH PROMOTION STRATEGIES/METHODS:
B. Use of Behavioral Change Theories
❑ Stages of behavior change
➢ Pre-contemplation
➢ A condition in which people are not thinking about change or have
expressed no interest in change
➢ Contemplation
➢ The period in which people are seriously thinking about the behavior
change
➢ Preparation and Action
➢ Period when an effort to try the behavior change is undertaken
➢ Confirmation
➢ The period when people can now maintain the new behavior
STRATEGIES/METHODS IN HEALTH EDUCATION/
PROMOTION
CLASSIFICATION OF HEALTH PROMOTION STRATEGIES/METHODS:
B. Use of Behavioral Change Theories
❑ Stages of behavior change and Task of Appropriate Strategies
Stages of change Task of strategies
Pre - contemplation Create awareness and interest
Contemplation Change values
Preparation and Create opportunity for action
action
Confirmation Maintain change
STRATEGIES/METHODS IN HEALTH EDUCATION/
PROMOTION
CLASSIFICATION OF HEALTH PROMOTION STRATEGIES/METHODS:
C. According to target factors
➢Communication
➢Targeting the predisposing factors
➢Training
➢Target enabling factors
➢Community organizing/social mobilization
➢Targeting environmental and reinforcing factors
STRATEGIES/METHODS IN HEALTH EDUCATION/
PROMOTION
Communication Methods
Classification of Communication Methods:
1. Interpersonal
❖ Direct, face-to-face encounter between two groups or groups.
✓ Individual
o Counselling;individual instruction;home visits;referrals;risk assessment;patient education
✓ Group
o Lecture;small group discussions;forum;seminars
▪ Advantages of Interpersonal Communication
▪ Two way flow of communication
▪ Can fit to the local/individual needs
▪ Allows for immediate feedback
▪ Allows for in – depth discussion of a topic
▪ High capability to select particular audience
2. Mass media
❖ Use of television, radio and print
❖ Social marketing and Folk media are relevant strategies/method in health promotion
STRATEGIES/METHODS IN HEALTH EDUCATION/
PROMOTION
Skills in Interpersonal Communication:
1. Use of non – verbal communication
▪ Important in sharing and interpreting information about feelings
▪ Varies from culture to culture
2. Active listening
▪ The ability to respond to a person/group in a way that will help them
clarify thoughts and feelings
▪ A skill that must be learned and developed
3. Recognizing information about feelings and ideas
▪ Careful attention must be paid to cues, tone of voice, choice of words ,
facial expressions and posture
4. Questioning and responding skills
▪ Questioning and response is fundamental to a successful
communication
