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نقش آموزش د رارتقاء سلامت خانواده The Role of Education on Family Health دکتر محمد کمالی استاديار دانشکده علوم توانبخشی دانشگاه علوم پزشکی ايران [email protected] تهران - صندوق پستی 183-17445 Is There a Difference Between Health Education and Health Promotion?

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نقش آموزش د رارتقاء سلامت خانواده

The Role of Education on Family Health

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دکتر محمد کمالی خانواده

استاديار دانشکده علوم توانبخشی

دانشگاه علوم پزشکی ايران

[email protected]

تهران - صندوق پستی 183-17445

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Is There a Difference Between Health Education and Health Promotion?

  • Health education: learner directed

  • Health promotion: broader concept directed toward advocating health:

    • Individual and community education

    • Environmental change

    • Policy changes

    • Economic changes

    • Shifts in societal norms

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I. What is Health Promotion? Promotion?

  • A broad field encompassing educational, social, economic, and political efforts

  • Practiced in many settings

  • An unifying concept that brings together many separate fields

  • Allows people to take control and responsibility for their health

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II. The Triad of Health Promotion Promotion?

  • Prevention

  • Health Protection

  • Role of Health Education

  • Relationships Among the Triads

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Prevention Promotion?

  • Primary Prevention – interventions to avert disease, illness, injury, or deterioration

  • Secondary Prevention – identifies disease at its earliest stages and applies appropriate measures to limit the consequences

  • Tertiary Prevention – prescribes specific interventions to limit the effects of disabilities and diseases and to prevent recurrence of disease

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Health Protection Promotion?

  • Legal or fiscal controls, regulations and policies, and voluntary codes aimed at positive health

  • Health promoters overcome many health barriers to health protection

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Role of Health Education Promotion?

  • The core of the total health promotion program

  • A planned process which usually combines educational experiences to establish healthy behaviors

  • Educate individuals, media, elected officials, and community leaders about health

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Relationships Among the Triad Promotion?

  • Triad should be viewed as an interlocking set of spheres of activity

  • Seven domains produced by the relationships

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III. Framework for Health Promotion Promotion?

  • Three levels of concern and action

    • Health challenges

    • Health promotion mechanisms

    • Implementation Strategies

  • Explores biopsychosocial processes that motivate individuals to engage in behaviors

  • Health promotion triad runs through framework

  • Most important challenge is reducing health inequities between low- and high-income populations

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IV. Special Themes in Health Promotion Promotion?

  • Empowerment – people assuming control over their lives

  • Ecological perspective views as a product of the individual and subsystems of the ecosystem (family, culture, physical, social environment)

  • Community organization – multi-phased process helping to produce change and develop the community

  • Individual behavior plays a key role in one’s health

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The concept of health Promotion?

  • The concept of health is defined as the state of body and mind which affords the individual the ability to strive toward his/her functional objectives and his/her culturally desired goals.

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Popular Definition of Promotion?Health Education

  • Any combination of learning experiences designed to facilitatevoluntary adaptations of behavior conducive to health.

    • Green, Kreuter, Deeds, & Partridge, 1980

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Ultimate Goal of Health Education? Promotion?

  • Enable people to increase control over their health and quality of life.

  • Empowered learners feel competent and confident about making health decisions that are right for them.

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Health Education Produces Health Literacy Promotion?

  • Capacity of individuals to obtain, interpret, and understand health information and services.

  • Competence to use such information and services in ways which enhance/maintain health of self and family members.

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World Health Organization (WHO) Promotion?

  • has recently defined health literacy more broadly, as follows:

    • Health literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health.

    • Health literacy means more than being able to read pamphlets and successfully make appointments.

    • By improving people’s access to health information and their capacity to use it effectively, health literacy is critical to empowerment. (WHO, 1998)

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Whatever definition you choose… Promotion?

  • “…one fundamental principle must guide the work of health educators:

    • Individuals

    • Families, and

    • Communities

      Can be taught to assume responsibility for their own health and, to some extent, for the health of others.” Butler, 2001

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The challenge is… Promotion?

  • “…to find the most productive ways to influence voluntary individual and community behavior without violating individual freedoms ...” Butler, 2001

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Effective Health Instruction Promotion?

  • “What to teach and how to teach it.”

    • Dalis, 1994

  • Knowledge does not always change attitudes or behavior

  • Attitudes are not always consistent with behavior

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    Effective Health Instruction Promotion?

    • Conduct interventions to reach a number of generic outcomes including:

      • Skill development

      • Values awareness

      • Concept and information acquisition and application

      • Opinion development and discussion

      • Decision making

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    The process of health education… Promotion?

    • Is a part of a sequential program that introduces concepts at appropriate learning levels and that is based upon what was learned previously, which forms a basis for what is to be learned in the future.

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    The process of health education… Promotion?

    • Emphasizes in a comprehensive manner how various aspects of health are interrelated and how all aspects affect quality of life

    • Includes interaction between a qualified educator and learner.” Butler, 2001

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    Health Education Practice Promotion?

    • “…is that multidisciplinary practice…concerned with designing, implementing, and evaluating educational programs that enable individuals, families, groups, organizations, and communities to play active roles in achieving, protecting, and sustaining health.”

      Report on the Joint Committee on Health Education Terminology (1990).

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    Steps to Develop a Health Education/Promotion Program Promotion?

    • Assessing the needs and assets of the target population

    • Prioritizing needs based on available resources, available data, & experience

    • Developing appropriate goals and objectives

    • Creating an intervention that considers the peculiarities of the setting

    • Implementing the intervention

    • Evaluating the results

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    Home and Family Influence on Education Promotion?

    Active capital: where parents are active and interact with children and schools and community.

    Passive capital: parents provide children with resources for education.

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    Active and passive capital Promotion?

    • Both types of capital can influence the educational achievement, however, active capital in particular can have a significant impact.

    • e.g. John Stuart Mill at an age before most children attend school was taught Latin and Greek by his father…he most likely did not have extraordinary genes, and his fathers’ learning was no more extraordinary than some men of the time...the central difference was the time and effort spent by his father with the children on intellectual matters.

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    Parenting Styles: Promotion?

    Authoritarian Style – based on rigid adult oriented rules.

    Authoritative Style – based on firm consistent control

    Permissive Style – based on accepting, positive and warm approach in conjunction with few demands.

    Indifferent-uninvolved – barely involved with family life.

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    Other factors in parental influence: Promotion?

    • Parental Encouragement – can be active or passive and tends to have a positive effect on a educational programs.

    • Parental Expectations – can have an effect on post-secondary expectations

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    Parents education Promotion?

    • Parental Education– tends to have a strong impact on all other factors because parents with higher education tend to spend more time with children helping with homework, and difficult assignments.

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    Family Needs Promotion?

    • Communication Needs

    • Information Needs

    • Guide on life Tasks

    • Consultation Needs

    • Economic and Financial Needs

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    Family Education Promotion?

    • Individual Education

    • Group Education

    • Mass Education

    • Self Education

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    New Ideas and Practices Promotion?

    • Awareness

    • Interest

    • Evaluation

    • Trial

    • Adoption

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    Friends Promotion?

    Support Group Members


    Medical and Rehabilitation Team



    Casual Acquaintances (e.g. waiting room)







    The Family Perspective

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    Practice of Health Education Promotion?

    • Individual and family

    • Education to general public

      • T.V

      • Radio

      • Press

      • Films

      • Health magazine

      • Posters

      • Health exhibition

      • Health museum

    Mass media is less effective

    in changing human behavior

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    Lectures Promotion?

    Film and charts

    Group discussion

    Panel discussion




    Role playing


    Programmed instruction

    Stimulation and exercise

    Group Health Education

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    Keep in mind Promotion?

    Human Behavior is Complex

    Participants/clients/patients base their opinion on their perception

    • How relevant the program or health education seemed to be in terms of their needs

    • How interesting it was in terms of subject matter and learning activities

      Tips: Assess the learner perceptions early

      Adapt/adjust activities if needed

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    Stages of Successful Education Promotion?

    • Audience analysis

    • State objectives

    • Select media and materials

    • Utilize media and materials

    • Require learners participation

    • Evaluation and revise

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    Peoples Education Promotion?TIPS

    • Discuss; DON’T LECTURE!

    • Consider circumstantial & socio-economic factors

    • Respect cultural/spiritual beliefs and attitudes

    • Ask the people what they understand about the health issue

    • Assess the people’s readiness for change

    • Keep it simple

    • Reinforcement, reinforcement, reinforcement

    • Relapse is part of changing behavior

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    What is principally Promotion?wrong with Health Education?

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    Health Crisis is running faster Promotion?





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    Do you Agree? Promotion?

    Health Education

    is moving in the right direction –

    but much too slowly

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    1969 The Beginning Promotion?

    1971 Soon After…

    More Recently…

    The Internet

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    Appropriate technology can revolutionize… Promotion?

    • The delivery system of products and services

    • The way we communicate

    • The way we use and view television

    • The way we individualize and personalize education

    • The way we internalize, understand, and use massive amounts of data

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    Medical Doctors and other Health Professionals as Consultants of Health Educators

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    Medical Doctors as Health Educators Consultants of Health Educators

    „I´ll give you NOT a MEDICATION, but an EDUCATION!“

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    We Should to Think Consultants of Health Educators

    • If we have so many best practices

    • Why can’t we figure out how to get health educators to use them effectively?

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    The Last Word Consultants of Health Educators

    “I never teach my pupils. I only attempt to provide the conditions in which they can learn.”

    Albert Einstein

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    The role of health education Consultants of Health Educators

    • The role of health education should be to impart knowledge which will assist individuals in making personal choices about lifestyles, values, and goals.

    • Health education should recognize that notions of health are human constructs which are restricted by man's interpretation of the functional integrity of the body and mind and relative to the activities and interests of individual societies.

    • The function of health education should be to impart knowledge for the purpose of developing the powers of reason and judgment in order to help people make their own choices about patterns of living which enhance the well functioning of the body and mind.