Health and safety education for worker empowerment.

This article introduces a special issue of the American Journal of Industrial Medicine dedicated to innovative approaches to worker education in health and safety. Contributors to this issue describe applications of an "empowerment approach" in a wide variety of institutions and settings throughout the United States and Canada. In this article, empowerment education is presented and contrasted with other training methodologies. The article offers suggestions on how to implement this approach discusses evaluation issues, and summarizes the articles contained in this issue. Explored are preliminary outcomes of using this methodology and implications for developing educational programs in the future.     

北京市大学生性健康/生殖健康教育需求的定性研究

北京市大学生性健康／生殖健康教育需求的定性研究结果显示：在首都高校开展全面的性健康／生殖健康教育并提供可及的生殖健康服务是广大青年学生自己的心声、愿望和共同需求;实施大学生性健康／生殖健康项目应实行性道德教育和安全性行为教育相结合方式;开展的具体方法应遵循以下原则;（１）多种形式并用,以便不同对象各取所需;（２）非（或低）敏感话题采用群体干预。而高度敏感话题采用个别辅导形式;（３）感话题采用群体干     

Barriers and Facilitators for Promotoras’ Success in Delivering Pesticide Safety Education to Latino Farmworker Families: La Familia Sana

ABSTRACT

Despite widespread use of lay health advisor (LHA) programs, factors related to success of LHAs remain largely unexamined. This study describes experiences and personal transformations of LHAs (promotoras de salud) in a pesticide safety education program targeting farmworker families in North Carolina, using postintervention in-depth interviews conducted with 17 LHAs. LHAs identified assets and barriers that affected their success. LHAs also described increases in self-efficacy and empowerment resulting in perceived improvements in ability to teach and impact their community. Such positive changes are essential benefits to the LHAs. Evaluations that address these topics are needed to better understand continuity and attrition in LHA programs.     

Measuring success in a pesticide risk reduction program among migrant farmworkers in Colorado

BACKGROUND: Farmworkers in the US largely consist of young undocumented Hispanics with a median education of 6 years and limited English skills. The High Plains Intermountain Center for Agricultural Health and Safety bilingual pesticide risk reduction program, which complied with the Worker Protection Standard for migrant farmworkers was evaluated. METHODS: A pretest/posttest comparison of farmworkers (n = 152) assigned to either the experimental or control group was used. Independent variables included demographics, agricultural experience, and health locus of control. Dependent variables were pesticide knowledge, safety risk perception (SRP), and safety-behavior outcomes. RESULTS: The bilingual pesticide program effectively increased farmworker's pesticide knowledge (P = 0.0001), SRP (P = 0.0001), and two (out of four) behavior outcomes. Workers with external health locus of control were less likely to adopt safety behaviors (P = 0.0001). CONCLUSIONS: The cognitive decision-making process whereby farmworkers' readiness to change and permanently adopt safety behaviors was supported by the pesticide program. Our results support the need for long-term sustained bilingual, intervention programs that demonstrated effectiveness using integrative methodology.     

CONTINUING PROFESSIONAL EDUCATION: A CHALLENGE FOR RURAL HEALTH PRACTITIONERS

ABSTRACT: Health professionals in rural and remote areas of Australia are disadvantaged when accessing continuing education. Their geographical isolation influences attendance at seminars, workshops and even informal discussions with colleagues. This paper describes the strategies adopted to meet the continuing education needs of a group of health professionals working in diabetes education and discusses how other specialist areas can provide similar educational opportunities. The education programs for isolated health professionals involved in diabetes care in South Australia were created by a team, and the resources of their associated institutions. Formed working agreements were established to achieve the aim of relevant continuing education for rural health professionals and to ensure ongoing ventures. All programs have been positively received, and evaluations identify the need to develop other, related subjects. Future developments will further utilise advances in technology to extend access and add to the current modes of education delivery. It is the intention of this group to continue to develop practice-based subjects capable of meeting rural health practitioners' needs and thus enhance the quality of care in rural and remote communities.     

Accreditation of Undergraduate and Graduate Medical Education: How do the Standards Contribute to Quality?

Accreditation organizations such as the Liaison Committee for Medical Education (LCME), the Royal College of Physicians and Surgeons of Canada (RCPSC), and the Accreditation Council for Graduate Medical Education (ACGME) are charged with the difficult task of evaluating the educational quality of medical education programs in North America. Traditionally accreditation includes a more quantitative rather than qualitative judgment of the educational facilities, resources and teaching provided by the programs. The focus is on the educational process but the contributions of these to the outcomes are not at all clear. As medical education moves toward outcome-based education related to a broad and context-based concept of competence, the accreditation paradigm should change accordingly.     

Effectiveness of an educational program to promote pesticide safety among pesticide handlers of South India

Objectives Occupational poisoning with pesticides is common in developing countries because farmers are often under trained, illiterate and consider it impractical and expensive to use safety equipment, especially in tropical climates. Greater benefit of education programs on prevention can be obtained if initiated in areas having higher occurrence of poisoning. Hence, the present study evaluated occurrence of poisoning and effectiveness of educational interventions among pesticide handlers in areas having high occurrence of occupational poisoning. Methods Two villages of Udupi district of South India were identified by spot mapping and targeted for a public education program on safe handling of pesticides, the impact of which was assessed using a knowledge attitude and practice (KAP) questionnaire. Education was provided using a structured individualized training program to 74 pesticide handlers. Three point KAP assessments were carried out at baseline, immediately after training and after 1 month of training. Nonparametric Kruskal–Wallis tests and Friedmann tests were used to compare scores at different time points and between groups. Results Occurrence of occupation related poisoning was 33% and common in three villages of the district. The average baseline KAP score of 30.88 ± 10.33 improved after education significantly (P < 0.001) at first follow-up 45.03 ± 9.16 and at second follow-up 42.9 ± 9.54. A decline of score between the first and second follow-up may be attributed to decline in knowledge retention. Demographics like gender, literacy and presence of children affected KAP score and there was no influence of geography, age or frequency of pesticide use. Conclusions Educational intervention among pesticide handlers improved the KAP score for safe pesticide handling. We recommend that continuous education and training programs for agricultural workers will promote awareness and minimize the hazards of occupational pesticide exposure.     

Un lugar seguro para sus ninos: development and evaluation of a pesticide education video

The need exists for culturally appropriate and effective educational interventions to reduce pesticide exposure in migrant and seasonal farmworker (MSFW) communities. The development of one such intervention was part of a community-based research project which partnered the Oregon Health Sciences University and the Oregon Child Development Coalition (Migrant Head Start). The process involved identifying an optimal educational method and content, evaluating existing educational materials on pesticides, developing the selected educational tool (a video), and assessing the effectiveness of the video as an intervention.Focus groups were conducted with MSFWs to elicit their perceived need for education and desired content, method, and delivery. Four currently used educational tools were evaluated for satisfaction, preference, recall ability and knowledge change. Based on these findings, a pesticide exposure video directed at the protection of children was produced. To determine the effectiveness of the video, knowledge, satisfaction and self-reported behaviors were assessed with MSFWs. A sizeable increase in overall pesticide knowledge was measured after seeing the video (p < 0.0001). MSFWs overall were satisfied with the video and reported increased protective behaviors after seeing the video.     

Safe Handling of Agricultural Pesticides in Minnesota: Results of a County-wide Educational Intervention

Safe pesticide handling in a group of Minnesota farmers, aged 40 years and older, was influenced through the use of a multifaceted, countywide educational intervention. Two intervention counties and two control counties were involved in this effort. The intervention consisted of mailed pesticide information to farm households, educational programs on pesticides for county physicians, elementary school training modules on pesticides and the use of safe pesticide handling displays in key business areas by agricultural extension agents. Five hundred eight farmers were identified as pesticide users (186 in the intervention counties and 322 in the control counties). The use of gloves and other protective clothing while handling pesticides increased in the intervention group. Improvement was greater in those who had used protective equipment the least before the intervention. From these results, it appears that a broad-based educational intervention might have a modest impact in how farmers protect themselves when using pesticides.     

量化健康教育在糖尿病教育中的应用效果分析

目的考察量化健康教育在糖尿病教育中的应用效果.方法将143例住院糖尿病患者按年龄和文化程度平均分为量化健康教育组和随机健康教育组,分别按两种模式对患者实施教育,并对教育后效果进行统计学比较分析.结果大部分患者疾病知识掌握和血糖控制程度能令人满意,统计学分析结果显示量化健康教育组和随机健康教育组在宣教内容掌握率、血糖控制达标率和患者满意度三方面是有差别的,量化健康教育组明显优于随机健康教育组.结论量化健康教育应用于糖尿病患者教育中效果较好.     

Selected Organizational and Managerial Aspects of Health and Nutrition Education of Various Types of Consumers of Spa Treatment Services in Poland

Consumer education, including nutrition education, understood as a process based on scientific principles, is becoming a very effective element in influencing the health of the population in the modern world. This work is based on direct research carried out in 2016–2018 in the form of a questionnaire interview among patients—consumers of educational services in spa treatment facilities. The research sample was N = 1000 (600 people were tested with the use of PAPI (Paper and Pencil Interview), and 400 people with the use of CAWI (Computer-Assisted Web Interview)) and concerned a representative group of spa patients in Poland. In addition, as a supplement, a direct survey was conducted in the form of a Computer-Assisted Telephone Interview with managers of spa treatment facilities (N = 50). Consumers of spa treatment services differ from each other, and types can be distinguished based on their professional activity status and the type of entity that pays for their stay in the spa, and, using cluster analysis, the status of professional activity in relation to their education level. The nutritional education system is based on highly specialized medical personnel. At the same time, it does not use the available assessment tools based on proven monitoring and evaluation indicators. Health education, which also includes nutritional education, apart from disease prevention, is the basic tool for health promotion in spa treatment conditions, enabling the introduction of a permanent change in the patients’ lifestyles, the additional advantages of which are low costs and relatively high efficiency. In the course of the study, several useful patient profiles were also distinguished, thanks to which it is possible to select dedicated educational methods for selected groups of recipients.     

在学生减负的背景下结合素质教育探讨学生控烟模式的研究

目的：在学生减负的背景下，结合素质教育探讨学校－家庭－社区控烟模式。方法：以学生为中心，让学生自主设计并实施控烟活动，技术人员引导、观察、督导控烟活动，并进行干预前后KAP（知、信、行）调查及专题小组访谈等定性、定量评价。结果：通过开放式控烟活动，学生开展了适合学生年龄特点、丰富多采的控烟活动，使学生及其家长提高了对烟草危害的认识，其吸烟行为发生了明显改变，并为学校的素质教育提供了有益的尝试。结论：结合素质教育开展控烟活动，符合教育和卫生部门的发展要求和发展方向，可持续发展，是学生素质教育和综合能力培养的重要内容。     

An occupational health and safety intervention research agenda for production agriculture: Does safety education work?

It is clear that agriculture has not kept pace with other hazardous industries in reducing its injury rate. For example, between 1960 and 1990 the work death rate for agriculture decreased only 28% while the work death rates decreased 65% for mining and 55% for construction [Purschwitz (1992)]. A national conference in Iowa in 1988 came to the forceful conclusion that “America's most productive workforce was being systematically liquidated by an epidemic of occupational disease and traumatic death and injury” [NCASH (1988)]. In 1991, the nation's top public health officer, the U.S. Surgeon General, convened a conference titled “FarmSafe 2000—A National Coalition for Local Action,” to formally address agricultural safety and health issues. Importantly, conferees recognized that preventing injury and disease was superior to trying to rehabilitate people after an injury occurred. But does participation in farm safety and health educational programs lead to a reduction in risk of injury from farm work? Questions are being raised about the value of farm safety and health educational information, campaigns, programs, and related activities. The questions have identified a critical gap in the literature of farm safety and health education. There is currently no good evidence demonstrating that farm safety and health education, campaigns, programs, or related activities lead to a relatively stable reduction of risk on the farm. In other words, do farmers and their families actually put to use, in a relatively permanent or stable manner, the educational information regarding elimination, reduction, or control of physical hazards and the modification of work behavior that may cause injury? © 1996 Wiley-Liss, Inc.     

Influence of Materials on Teacher Adoption of Abstinence-Only- Until-Marriage Programs

BACKGROUND: Given the growing scientific evidence against abstinence-only-until-marriage education, health educators are supporting an evidence-based approach to teaching sexuality education. However, there is still an abundance of federal support and funding streams allocated to sustain abstinence-only programs. This study assessed indicators that influence the adoption of abstinence-only-until-marriage education as well as school teachers' likelihood of adopting such programs.
METHODS: Predictors included relative advantage, compatibility, complexity, and observability and were assessed with a self-administered, validated questionnaire. Additional questions were asked related to demographics, professional history, and abstinence-only-until-marriage education policies and funding. The relationships were tested with multiple regression analysis.
RESULTS: A trend became apparent in which most teachers would allow a state- or federally funded program to be offered and presented in their schools, but most did not know if their school received funding to support abstinence-only-until-marriage education. Attendance at religious services, complexity of abstinence-only-until-marriage programs, and abstinence-only-until-marriage curriculum emerged as important predictors of the likelihood to adopt abstinence education.
CONCLUSIONS: Trends in political agendas, policy development, and state and federal funding have supported abstinence-only-until-marriage education programs. In order to ensure an understanding about the inclusion of sexuality education in the classroom, insight into the teacher's role in the integration of sexuality education in the classroom is important.     

Barriers to Nutrition Education for Older Adults,and Nutrition and Aging Training Opportunities for Educators,Healthcare Providers,Volunteers and Caregivers

Abstract

Literature citations of barriers to nutrition education found in those who teach and care for older adults, as well as within older adults themselves, are discussed. No attempt was made to compare educational barriers for learners of varying ages. These obstacles need to be addressed in order for nutrition to be taught or learned effectively so that nutrition practices and health improve. Barriers for healthcare professionals to providing nutrition education include misconceptions and stereotypes about older adults and about their nutritional concerns; lack of attention to and lack of funding for older adult educational programs; and difficulties recruiting older learners. Hindrances for older adults in responding to nutrition education can be categorized as attitudinal, motivational, environmental, and related to low literacy and poverty. Published examples of opportunities for education and training about nutrition and aging that are in place for health educators, healthcare providers, volunteers and caregivers regarding nutrition and aging are discussed. Suggestions are presented regarding future efforts to minimize educational barriers and to provide training for healthcare professionals, volunteers and caregivers. New research is needed in this field of study in order to realize the potential quality of life benefits and reduced healthcare costs associated with providing effective nutrition education to older adults. This is one of a series of reviews of recent literature on nutrition education for older adults.     

Increasing Awareness of Danger Signs in Pregnancy Through Community- and Clinic-Based Education in Guatemala

Objective: This study evaluates the effectiveness of a set of information, education, and communication (IEC) strategies designed to increase the awareness of danger signs in pregnancy, delivery, or the postpartum period among pregnant or recently pregnant women. Methods: Three IEC programs were implemented in 4 regions of southwestern Guatemala between April 1997 and May 1998: (1) a clinic-based program involving the training of health providers in prenatal counseling and the provision of educational media to clients; (2) a community-based strategy consisting of radio messages regarding obstetric complications; and (3) educational sessions conducted through women's groups. Three surveys were conducted. In 1997, 637 pregnant women were interviewed at clinics where the interventions had been implemented. In 1998, 163 pregnant women using a subset of the same health clinics were interviewed. In 1999, a population-based survey of 638 pregnant and postpartum women was conducted. Using logistic regression, we model awareness of danger signs as a function of sociodemographic characteristics, prenatal care utilization, and IEC interventions. Results: Among women using health clinics, the likelihood of having heard of danger signs nearly tripled between 1997 and 1998, when the clinic interventions were fully implemented. In 1999, those who had heard radio messages or participated in women's groups were, respectively, 3 times and 5 times more likely to have heard of danger signs in pregnancy. Conclusions: Safe motherhood programs can effectively increase knowledge of danger signs through clinic- and community-based educational strategies.     

农村儿童营养不良相关因素调查及干预策略探讨

为了解儿童营养不良的相关因素,探索用健康教育干预的方法控制儿童营养不良,为制定改善儿童健康的策略提供科学依据,采用健康教育干预的方法,对福建省经济发展水平不同的两个县的所抽学校的小学生进行行为干预,并对实验组和对照组的近2000名学生作问卷调查和体检,同时对其家长调查,以确定干预效果。结果发现干预前小学生及其家长的营养卫生知晓率低下,小学生营养不良率达36．8％,缺铁性贫血患病率达42．5％。经过干预,缺铁性贫血患病率下降3．7％,营养不良率下降8．6％。健康教育是改善儿童营养状况的有效手段,应加强对小学生及其家长营养知识教育和行为干预。     

试论卫生科教影视片在健康教育中的优势

卫生科教影视片,不仅是一种宣传和教育手段,也是一种视觉艺术。它不但给人音乐、语言、形象融为一体的美的享受,而且观众能从影视画面中了解卫生科学知识,受到启迪,得到教益。因此,卫生科教影视片同其他传播卫生知识的手段相比,在健康教育中的优势更加突出。     

Original Research: Lesbian Health Education: A Survey of Obstetrics and Gynecology Residency Training Programs

The purpose of this study was to assess the status of lesbian health education in obstetrics and gynecology training programs in the United States and Canada. A survey was conducted of program directors of all accredited North American obstetrics and gynecology residency training programs. The response rate was 42% (118/283). The mean number of hours devoted to lesbian health education over the 4 years was 1.86 hr (n = 118 programs), with the most frequent method of instruction being lectures and seminars. More than half of the programs offered no instruction in lesbian health. Seventy-three percent of program directors felt that the lesbian health training was less than adequate, and 71% perceived a need to expand the lesbian health curriculum in their programs. In conclusion, lesbian health education is variable across institutions. The current status of lesbian health education is felt to be inadequate by program directors and there is a perceived need to expand the lesbian health curriculum in obstetrics and gynecology training programs.