Health education: a boon to humanity or a fantasy and fraud?

The health education profession in the United States has been influenced by three major forces in recent years: sociomedical phenomena resulting in a public demand for health education, disease specificity of the practice of health education, and the process of professional credentialing. While these three forces are looked upon by many as beneficial to the profession, they also pose significant threats to the viability of the profession. Health educators must deal with these threats if the health education profession is to significantly benefit humanity. Otherwise, the profession may be ultimately perceived as a fantasy and fraud.     

Role modeling: an opportunity for the health education specialist.

It is the responsibility of the profession to determine what is right, reasonable, and ethical health education practice. Opportunities within the profession abound to deliberate about the responsibility of health education specialists to role model positive health behaviors. Davis summarized the espoused perspectives nicely: We owe it to our profession and to our students to personally travel as far on the wellness continuum as behavioral choices will permit.... Health educators do have a special responsibility to be positive health role models by fulfilling their health potential and modeling the healthiest behaviors of which they are capable. All health educators need to accept for themselves the responsibilities that we assign to others.     

A descriptive analysis of patient education courses in undergraduate and graduate health education programs

Patient education is a necessary component of quality health care, yet little attention has been given to the preparation of health educators to work in that setting. This study seeks to determine the status of and content in patient education courses offered in professional preparation programs. Results show that 9% of respondents offered a patient education course in their academic unit, whereas 18% indicated that such a course was offered in another unit on campus. It appears there is not agreement between university faculty members and practicing patient educators on what should be taught in such a course. In addition, no significant relationship is found between (a) programs with accreditation or approval and offering a patient education course and (b) programs that prepared students for the Certified Health Education Specialist examination and offering a patient education course. Recommendations are offered for improving the preparation of health educators for the medical care setting.     

Challenges in teacher preparation for school health education and promotion

The health education and promotion profession is facing a series of teacher preparation challenges related to the delivery of quality school health education/promotion programmes. The challenges occurring in the United States are also present in a variety of other regions as the education structure attempts to ensure that students receive a sound preparation in health education and promotion during their school experience. The challenges can be categorised into the following areas: Quality and quantity of professional preparation for teachers during their pre-service university training; Need for in-service of teachers already in the K-12 workforce (in the USA grades K-12 are broadly equivalent to ages five to 17 years); University faculty workforce professional development needs; Research to provide baseline data for future standards development. Because there is a direct connection between community and school and parents and teachers at the K-12 level of education, the demand for highly skilled teachers and professional development is playing out at that level much more rapidly than at the university level. The relative isolation of some university faculty and programmes has developed an interesting situation in which many administrators and master teachers at the K-12 level of education have a better grasp and understanding of new teaching and learning strategies and tools than professors at the university level. This has happened at the same time when there is also a shortage of university professors entering school health education/promotion teacher education. This confluence of realities may predicate the need for a radical change in university based teacher preparation in health education/promotion. The overwhelming challenge for many countries including the United States remains the large number of teachers in the current workforce who must be provided professional development experiences. Currently both the National Health Education Standards for K-12 students and teacher preparation standards in health education reflect best practice theory only. There is no national data to support the standards. During the next ten years it is imperative that nationwide data be collected, compiled and analysed on actual learning outcomes for both K-12 students and health education teacher candidates. This will allow the next set of standards at both of the above-mentioned levels to reflect the knowledge and skills that have been actually attained and demonstrated. It will also be a basis for creating revisions and expansions in such a way that national standards can be an actual measure by which student performance can be judged. It is hoped that the rising tide of both national and international interest in having an increasingly health literate population will inspire members of the profession to be creative in the development of educational approaches, strategic partnerships, and funding to put strong systems of teacher preparation in place for the future.     

Teacher beliefs, professional preparation, and practices regarding exceptional students and sexuality education

Sexuality education, part of the comprehensive school health education component of a Coordinated School Health Program, interests many health educators as well as special education teachers. In this study, Florida special educators reported their beliefs about teaching sexuality education to educable mentally disabled students, the range of sexuality topics they teach, and their professional preparation in sexuality education. Respondents (n = 494) completed a mailed instrument that included the 36 sexuality content areas identified by the Sexuality Information and Education Council of the United States. Respondents believed strongly that many of the sexuality topics and content areas should be taught to educable mentally disabled students. However, most reported delivering only a modest amount of sexuality education, and they rated their professional preparation as inadequate. Regression analyses documented that respondents' beliefs predicted the topics they actually taught within 5 of the 6 key concepts. This study supports collaboration between health educators and special education teachers to adapt existing sexuality curricula for students with special needs, improve professional preparation of special education teachers to teach sexuality education, and to more effectively implement comprehensive school health education through the Coordinated School Health Program model to special education students.     

FOUNDATIONS OF HEALTH EDUCATION

Health education is "the process of providing or utilizing experiences for favorably influencing understanding, attitudes, and practices relating to individual, family, and community health. As an applied science it draws its content from a variety of sources. The paradigm which depicts the foundations of health education can be visualized as five vertical pillars consisting of sociocultural, educational, psycho-behavioral, legal, and scientific foundations supporting the work of the health educator. While the components within each pillar may be altered with new developments and advances over time, the model is broad enough in scope to incorporate the changes without altering its purpose. The foundations of health viewed in this light can easily display the depth of the health education profession and will serve to orient the novice and future health educators of the underpinnings of their profession. This framework could easily be adapted for study on the college level and should serve as an orientation to those students planning to major in health.     

Health promotion and the older population: Expanding our theoretical horizons

As the year 2000 approaches (and beyond) more health educators will be involved in the implementation of health promotion programs and related activities specifically designed for the older population. Most health educators draw upon a variety of theoretical frame-works as they design programs. Traditionally, health education has been grounded in behavior change theories such as the Health Belief Model, the Theory of Reasoned Action, and Bandura's Social Learning/Cognitive Theories. When the focus is gerontological, however, an opportunity exists to expand health education's theoretical horizons by incorporating features drawn from gerontology itself. Principles of adult cognitive development, social gerontology and person-environment fit can potentially complement and supplement those models already in use as more programs are targeted for a growing older population.     

Continuing-education needs of public health educators: their perspectives.

The objective of the study described in this article was to determine the perceived continuing-education needs of employed public health educators. A three-wave mailing of a questionnaire was sent to a national sample of 500 public health educators who were asked to rate their preparation on 41 subcompetencies. Of 299 returned surveys (63%), 149 indicated that they were not currently practicing public health educators. Thus, analysis was based on 150 respondents. Six subcompetencies were perceived by 25% or more of the respondents as topics in which they needed more training. Health educators reported a need for continuing education, focused primarily on administration and evaluation of programs and applying appropriate research principles. Furthermore, the public health educators overwhelmingly preferred to attend a conference or workshop (85%) as their method of obtaining further continuing education. Health education programs and professional organizations need to take note of the identified continuing-education needs when developing future educational programs to adequately update health educators.     

EDUCATION FOR SOCIAL WORK IN HEALTH CARE ORGANIZATIONS

The American health care delivery system stands on the brink of major change and reorganization. There are many opportunities for the social work profession to increase its influence and expand the scale of its actiuities within health care. These opportunities represent a challenge to the uision, creativity, and flexibility of social work educators. This article discusses educators' roles within the context of a system conceptualization of the inputs, throughputs, and outputs of education for social work in health care organizations.     

Health education: a case for resuscitation

Health education is the component of health promotion designed to achieve learning related to health or illness. While often described by other names, an educational element features in nearly all health promotion activities. Unlike most other public health actions, it focuses on voluntarism and frequently on the individual. Health education and the resources devoted to it grew rapidly in the latter half of the 20th century. However, in the 1970s, many health educators started to question its value. They criticized it as being excessively concerned with disease, victim blaming, politically naive and increasing health inequalities. While promoting knowledge and skills for health was included as one of the five principles of health promotion in the World Health Organization's Ottawa charter, it received much less attention than the other four principles. Health education was also criticized as being ineffective. Methods for evaluating health education are hotly contested but there is evidence that some education interventions are effective. Current health strategies continue to advocate prevention through health education, and workers in many different settings are expected to ensure that health education is provided. These front-line educators should be able to look to those who specialize in health promotion to support their educational activities. This paper argues that the worth of health education compared with other forms of health promotion has been grossly underestimated and it is time to re-assert its importance.     

Assessment of public health educator practice: health educator responsibilities

This study presents a method for better understanding how practicing health educators in local health departments spend their time. The purpose of this study was to document the daily practice of health educators in the 10 areas of responsibility as defined by a competency-based framework for graduate-level health educators. The results of the current study present the average percentage of time health educators spent carrying out each area of responsibility and the percentage of health educators that did not carry out activities related to a specific area of responsibility. For example, the greatest percentage of time was spent implementing programs (21.2%), and approximately 60% of the health educators in the sample did not conduct research nor did they participate in activities to advance the profession. These findings have implications for the professional preparation of health educators and for their continuing education. The current study contains several suggestions for future research in this area.     

Ethical Issues in Research and Publication

Ethical considerations inherent in the process of research and publication represent one issue of particular concern to professionals. Members of a profession usually are guided by a code of ethics that specifies standards for practice. However, rarely do professional preparation programs sufficiently prepare students to deal with the concerns associated with research and professional publication. The authors address three specific areas of concern for health educators: the student-professor relationship, joint authorship, and ethics in publishing. Potential problems are discussed, and implications for the profession are cited.     

Use of cooperative health statistics system physician data in small area manpower needs assessment: the case of rural Colorado.

Maldistribution with respect of medical practice location and specialty continues to present barriers to quality care for many Americans. Residents of rural communities in Colorado often lack access to health care services appropriate in number and nature to their needs. A valid determination of the severity of inaccessibility of medical care is a prerequisite to effective programming for alleviating the problem. Any such needs assessment must be predicated on the use of a reliable, detailed physician manpower data base. Physician data used in evaluating the adequacy of health care delivery systems serving small or sparsely populated rural areas have traditionally proved inadequate, causing loss of credibility in the findings derived from those efforts. A concerted attempt was made in rural Colorado to establish a physician inventory for identifying health manpower shortage areas and assessing the degree of medical underservice. This undertaking was organized and directed by staff members of the Statewide Educational Activities for Rural Colorado''s Health (SEARCH) program, the area health education center program of the University of Colorado Health Sciences Center. Cooperative Health Statistics Systems (CHSS) physician data, collected in an annual survey conducted by the Colorado Department of Health, were determined to be exceptionally accurate in describing the physician manpower practicing in the State''s federally designated medically underserved counties. CHSS proved to be an outstanding source of physician data upon which small area manpower needs assessment can be based for the purpose of designating medically underserved or health manpower shortage areas.     

Development of certified health education specialists (CHES) in the United States: focusing on the CHES responsibilities and competencies

Health education is an important profession. The certification of health education specialists (CHES) has evolved in the United States (U.S.) over the past 50 years. This article briefly focuses on the CHES system in the U.S. and research studies related to this topic, including coverage of the CHES responsibilities and competencies by professional school programs in the U.S., as well as other CHES issues. The CHES credentialing system in the U.S. was successfully developed over a long period of time, and its history in the U.S. is unique. Japan has now started to develop a similar certification process and is concerned about academic programs for training Japanese health educators. Awareness of the CHES system and the U.S. health education certification process and framework may help Japanese health educators and academics to tailor their health education certification processes more effectively.     

Consumer health education: A new-old challenge to allied health education

The challenge to health education, implicit in the current re-thinking of the basic assumptions underlying U.S. health policy for the past quarter-century, is enormous and unprecedented in the history of the profession. This is true regardless of the fate of any particular bureau or piece of legislation. The challenge involves not only professional health educators but the far larger group of physicians, nurses, behavioral scientists, nutritionists and others involved in one or another aspect of this broad inter-disciplinary field. New manpower studies are urgently needed to identify quantitative and qualitative changes necessary to meet these challenges.     

Are Health Educators Being Prepared to Provide HIV/AIDS Education?: A Survey of Selected Health Education Professional Preparation Programs

Health education professional preparation programs were surveyed to determine the extent of HIV/AIDS education health educators are receiving. The survey also addressed content areas, skills being developed or enhanced, areas of deficiency in preparation programs, and areas in which national professional associations may assist in the preparation of AIDS educators. One hundred eight-three surveys were mailed; 114 (68%) were completed and returned. Twenty-one institutions reported planning a separate course on HIV/AIDS. Most were designing general service courses to reach a broad cross-section of students. Twenty-five institutions (23.8%) reported previously offering or currently offering a specific course on AIDS. One hundred two (89.5%) respondents reported HIV/AIDS warranted the attention and funding it had received. Thirty-seven (35.2%) respondents reported AIDS education was of sufficient importance to influence hiring of faculty members in their departments. Survey findings demonstrate that current AIDS education courses targeted to the general student population may not be adequate in meeting the professional preparation needs of health educators charged to provide AIDS education.     

A clinical education and practice placements in the allied health professions: an international perspective

This report describes the outcomes of extensive discussions surrounding clinical education and practice placement issues undertaken by an international group of allied health educators (in audiology, occupational therapy, physiotherapy, and speech pathology) who have met since 2001 as part of Universitas 21 Health Sciences annual meetings. The report outlines key issues associated with clinical education and practice placements from an international perspective and across these four allied health professions. The allied health practice context is described in terms of the range of allied health educational programs in Universitas 21 and recent changes in health and tertiary education sectors in represented countries. Some issues and benefits related to supervision during allied health students' practice placements are addressed. A new approach is proposed through partnership such that frameworks for the provision of practice placements can be created to facilitate student learning and educate and support clinical educators. A set of guidelines that can enhance partnerships and collaborative practice for the benefit of clinical education within complex and changing health/human service and educational environments is proposed.     

Training health educators for social change. 1984-85

Health education practice reflects the ideology of the social forces that support it. Currently, health educators approach their task from two divergent viewpoints: one group emphasizes changing individual behavior while the other focuses on organizing people to change health-damaging institutions, policies and environments. This report provides a rationale and examples of the latter approach. It then describes the kind of training program that would be necessary to prepare health educators to work effectively for social change. Specifically, it is suggested that graduate students in health education need more preparation in social epidemiology, environmental sciences and policy analysis, particularly the analysis of the impact of non-health policies on health status. Health education training programs also need new approaches to the process of learning. The social movement of the last decades, health education programs in developing and socialist countries and some projects in this country provide a rich source of case studies. Training programs also need to recruit students who will be prepared to serve populations most in need of help. This suggests attracting students who have in the past been excluded from graduate education. Finally, several methods are suggested by which students, faculty and practitioners can begin the process of transforming the institutions that prepare professional health educators.     

Toward a unified system of accreditation for professional preparation in health education: final report of the National Task Force on Accreditation in Health Education.

During the past 40 years, health education has taken significant steps toward improving quality assurance in professional preparation through individual certification and program approval and accreditation. Although the profession has begun to embrace individual certification, program accreditation in health education has been neither uniformly available nor universally accepted by institutions of higher education. To further strengthen professional preparation in health education, the Society for Public Health Education (SOPHE) and the American Association for Health Education (AAHE) established the National Task Force on Accreditation in Health Education in 2001. The 3-year Task Force was charged with developing a detailed plan for a coordinated accreditation system for undergraduate and graduate programs in health education. This article summarizes the Task Force's findings and recommendations, which have been approved by the SOPHE and AAHE boards, and, if implemented, promise to lay the foundation for the highest quality professional preparation and practice in health education.     

Health Instruction Responsibilities for Elementary Classroom Teachers in Pennsylvania

ABSTRACT: A joint committee comprised of representatives from the American School Health Association and the Association for the Advancement of Health Education delineated five areas of instructional responsibility and 31 competencies needed for elementary health educators. Practicing elementary educators in southeastern Pennsylvania were surveyed as to their usage and perceived importance of these health instruction responsibilities and competencies. Competency usage varied from a high of 98.6% to a low of 33.5%. The second area of instructional responsibility — Assessing the Health Instruction Needs and Interests of Elementary Students — had the highest mean usage per competency. Chi-square tests indicated a statistically significant relationship for competency usage and highest academic degree earned for two competencies, while competency usage and total number of years experience as an elementary educator indicated a statistically significant relationship for three competencies. The authors conclude with suggested strategies to improve the health education preparation of elementary educators. (J Sch Health. 1996:66(1):13–17)