HEALTH EDUCATION

EVIDENCED – BASED RELATED TO

HEALTH EDUCATION
Evidence based practice (EBP) or Evidence based is 'the integration of best
research evidence with clinical expertise and patient values' which when
applied by practitioners will ultimately lead to improved patient outcome.
In the original model there are three fundamental components of evidence
based practice.
 best evidence which is usually found in clinically relevant research that has
been conducted using sound methodology
 clinical expertise refers to the clinician's cumulated education, experience
and clinical skills
 patient values which are the unique preferences, concerns and
expectations each patient brings to a clinical encounter.
It is the integration of these three components that defines a clinical decision
evidence-based. This integration can be effectively achieved by carrying out
the five following steps of evidence based practice.
 THE 5 STEPS:
1. Formulate an answerable question
One of the fundamental skills required for EBP is the asking of well-built clinical questions. By
formulating an answerable question you to focus your efforts specifically on what matters.
These questions are usually triggered by patient encounters which generate questions about
the diagnosis, therapy, prognosis or etiology.
2. Find the best available evidence
The second step is to find the relevant evidence. This step involves identifying search terms
which will be found in your carefully constructed question from step one; selecting resources
in which to perform your search such as PubMed and Cochrane Library; and formulating an
effective search strategy using a combination of MESH terms and limitations of the results.
3. Appraise the evidence
It is important to be skilled in critical appraisal so that you can further filter out studies that
may seem interesting but are weak. Use a simple critical appraisal method that will answer
these questions: What question did the study address? Were the methods valid? What are
the results? How do the results apply to your practice?
4. Implement the evidence
Individual clinical decisions can then be made by combining the best available evidence with
your clinical expertise and your patients values. These clinical decisions should then be
implemented into your practice which can then be justified as evidence based.

5. Evaluate the outcome

The final step in the process is to evaluate the effectiveness and efficacy of your decision in
direct relation to your patient. Was the application of the new information effective? Should
this new information continue to be applied to practice? How could any of the 5 processes
involved in the clinical decision making process be improved the next time a question is
asked?
These steps may be more memorable if remembered as:
Ask
Acquire
Appraise
Apply
Audit
 TOWARDS AN IDEAL TYPOLOGY OF EVIDENCE
 One type of evidence can be found without meeting the causality criterion but where the different
elements of an intervention work as a whole to produce the desired outcome.
 Interventions that may have limited repeatability—for example, only at the local level and within a
certain period—can be classified as another type of evidence so long as the intervention works.
 The four classifications used in typology of evidence:
o Evidence of implemented interventions that meet the criteria for scientific fact—that is, they are
proved predictable, and repeatable, regardless of time and place.
o Evidence from interventions that produce desired outcomes and are predictable but are
repeatable only at a local level within a certain period of time.
o Evidence from interventions that work as predicted to produce desired outcomes, without
meeting the causality criterion, and are repeatable at any time and anywhere. Acupuncture is
an example for treating some illness conditions such as pain relief.
o Evidence from interventions that work as predicted, without meeting the causality criterion, and
are repeatable only at a local level within a certain period of time.
KNOWLEDGE BASED HEALTH PROMOTION
 Conscientious and judicious use of evidence is only one competency element of
health promotion. It is necessary but not sufficient for achieving effective health
promotion.
 Health promotion practitioners are required to be able to absorb and use
knowledge in many competency areas as specified in a review report.
 In policy formulation, while the strength of evidence is a base for policy
development, there are also other considerations, for example, the socio-political
and fiscal climate within which governments and organizations operate as well as
the vested interests.
 Effective health promotion often uses a combination of behavioral, social, and
environmental strategies that work in synergy. The relation between the outcome
variables and predictor variables are complex and not linear.
ETHICO-MORAL AND LEGAL FOUNDATIONS OF
CLIENT EDUCATION
 Nurses often share in intimate struggles and complexities of life and death decisions
with patients and families within any given clinical unit, practice setting, or designated
role.
 Knowledge generation from breakthroughs in genetics, genomics, precision medicine,
and other scientific areas test nurses' ability to keep pace with the ethical issues often
associated with these technological developments in both clinical care and research.
 Ethical issues also arise in everyday nursing practice. These issues may be concerns
affecting the nurse-patient relationship, including but not limited to, misunderstandings
associated with informed consent; conflict about treatment goals; power differentials
between and among healthcare clinicians, patients, families, and others; lack of
supportive resources and policies to guide practice decisions; truth-telling; and
disparities in access to care.
ETHICAL CONCERNS
 Correctional nursing allows the nurse to practice the essence of nursing while
recognizing that all patients have intrinsic value. Achieving and staying true to
professional nursing values while practicing in the correctional setting can create a
unique set of ethical, legal and professional issues for the nurse.
 For the nurse in a traditional medical setting, ethical decisions occur occasionally and at
times the nurse may face ethical dilemmas. In contrast, the correctional nurse may face
ethical situations daily. The correctional nurse makes ethical decisions about care
delivery, caring and patient advocacy in planning and providing safe patient care.
 There are six ethical principles that arise frequently for the nurse who works in the
correctional setting.
1. Respect for persons (autonomy and self-determination)
2. Beneficence (doing good)
3. Non-maleficence (avoiding harm)
4. Justice (fairness, equitability, truthfulness)
5. Veracity (telling the truth)
6. Fidelity (remaining faithful to one’s commitment)
 One of the common ethical concerns that arises for the correctional nurse relates to
demonstrating caring in a custody environment. Correctional nurses must find balance in
displaying an attitude of care and compassion while recognizing and maintaining safe
boundaries.
 Another area of ethical concern is the nurse’s responsibility for ensuring that patients have
access to care. The values associated with nursing practice include nurse advocacy, respect
for humans and eliminating barriers to care. The correctional nurse is in a unique position to
evaluate the quality and effectiveness of patient care.
 End-of life care is another ethical concern for the correctional nurse. Patients die while
incarcerated and the nurse has a role in helping the patient to die with dignity and comfort.
In some prisons, nurse participation in execution may arise as an ethical issue. The
correctional nurse should not participate in executions.
 The legal doctrine of “informed consent” is an important application of the principle of
autonomy. It is not as well understood by a practitioners as it should be. It is not sufficient to
tell a patient the risks and benefits of a medication or a procedure. The patient must be
told also of the risks and benefits of no treatment and of other options for treatment or
other medications that may (or may not) be efficacious.
LEGAL ISSUES
 The legal implications of nursing practice are tied to licensure, state and federal laws, scope
of practice and a public expectation that nurses practice at a high professional standard. The
nurse’s education, license and nursing standard provide the framework by which nurses are
expected to practice. When a nurse’s practice falls below acceptable standards of care and
competence, this exposes the nurse to litigation.
 The basis for litigation can relate to negligence, failing to exercise the level of care that a
reasonable, prudent nurse would under similar circumstances; malpractice; and professional
negligence, which means an act of neglect committed in the nurse’s professional role. Acts of
omission and commission will also subject the nurse to litigation and professional license review.
Both litigation and professional license review can result in reprimand of a nurse’s license or loss
of a license.
 The nurse has a legal and ethical obligation to respond to the request for care. In general, the
nurse should see the patient to evaluate health needs and determine the level of care required.
If the communication is from the officer to the nurse, the nurse has a responsibility to speak to
the inmate. A face-to-face discussion would be best, but the nurse could also first speak with the
inmate by phone, making sure to ask the right questions, and then determining if the inmate
should be moved to the medical unit or if the nurse should go to the inmate’s housing area.
SPECIFIC TRAITS OF THE INTERACTION BETWEEN
PROFESSIONS AND SOCIETY
1. Professions are autonomous, which gives the professional a considerable freedom
in the choice of methods and means within his/her professional activities and
meanwhile it makes impossible a constant supervision of his/her professional
conduct.
2. Professionals actualize their product in the most part as a result of individual
interactions. People are positioned physically close to each other during a
treatment, consultation, teaching, or a legal defense. Only the professional’s self-
consciousness can be a warranty for the patient against an abuse with his/ her
trust.
3. Professions bring social prestige to its members. The hopes and expectations that
society puts on them gives them a great power in terms of influencing the public
opinion and developing a public value system
HEALTH EDUCATION TEAM
A. ROLE OF THE NURSE AS A HEALTH EDUCATOR
1. Giver of Information - or as a communicator, the nurse understands that effective communication
techniques can help improve the healthcare environment. Barriers to effective communication can inhibit the
healing process. The nurse has to communicate effectively with the patient and family members as well as
other members of the healthcare team. In addition, the nurse is responsible for written communication, or
patient charting, which is a key component to continuity of care.
2. Facilitator of Learning - The nurse works with other healthcare workers as the manager of care and ensures
that the patient's care is cohesive. The nurse directs and coordinates care by both professionals and
nonprofessionals to confirm that a patient's goals are being met. The nurse is also responsible for continuity
from the moment a patient enters the hospital setting to the time they are discharged home and beyond.
This may even include overseeing home care instructions.
3. Coordinator of Teaching - a nurse provides hands-on care to patients in a variety of settings. This includes
physical needs, which can range from total care (doing everything for someone) to helping a patient with
illness prevention. The nurse maintains a patient's dignity while providing knowledgeable, skilled care.
Nurses care holistically for a patient. Holistic care emphasizes that the whole person is greater than the sum
of their parts. This means that nurses also address psychosocial, developmental, cultural, and spiritual
needs.
4. Advocate for the client – As a patient advocate, the nurse’s responsibility is to protect a patient’s rights.
When a person is sick, they are unable to act as they might when they are well. The nurses acts on the
patients behalf and support their decisions, standing up for his or her best interest at all times.
B. ROLE OF THE OTHER MEMBERS OF THE HEALTH TEAM
1. Primary care doctors: When patients need medical care, they first go to primary
care doctors. Primary care doctors focus on preventive healthcare. This includes regular
check-ups, disease screening tests, immunizations and health counseling. Primary care doctors
may be family practitioners, internal medicine or Osteopathic Doctors (OD's). Pediatricians
also provide primary care for babies, children and teenagers.
2. Physician's Assistants: are licensed to practice medicine and are supervised by a
doctor. Their training is similar to a doctor's but they do not complete an internship or
residency. Like a medical doctor, a physician's assistant can perform physical exams, order
tests, diagnose illnesses and prescribe medicine, assist in surgery, provide preventive
Healthcare counseling. Education for PA's includes a 4-year degree plus a 2-year Physician
Assistant program.
3. Advanced Practice Nurses (APN’s), Clinical Educators and Nurse Practitioners: work
with the staff nurses to educate and coach patients and their families; act as patient
advocates; and coordinate care for patients. Nurses assess, administer and monitor
treatments, help diagnose problems, and are watchful of any complications.
4. Pharmacists: give patients medicines that are prescribed, or recommended, by a doctor.
They tell patients how to use medicines and answer questions about side effects. Sometimes
pharmacists help doctors choose which medicines to give patients and let doctors know if
combinations of medicines may interact and harm patients.
5. Dentists: diagnose and treat problems with teeth and mouth, along with giving advice
and administering care to help prevent future problems. They teach patients about
brushing, flossing, fluoride, and other aspects of dental care. They treat tooth decay, fill
cavities and replace missing teeth.
6. Lab Technician: Laboratory Technologists help providers diagnose and treat disease by
analyzing body fluids and cells. They look for bacteria or parasites, analyze chemicals,
match blood for transfusions, or test for drug levels in the blood to see how a patient is
responding to treatment.
7. Radiology Technologists: also called radiographers, help providers diagnose and treat
disease by taking x-rays. For some procedures technologists make a solution that patients
drink to help soft body tissues can be seen. Radiology technologists are can specialize in
computed tomography (CT scans), Magnetic Resonance Imaging (MRI’s) or mammography.
8. Clinical Nutrition Services: include Registered Dietitians and Nutrition Technicians who work together
in consultation with other healthcare professionals to provide nutritional care and education. Clinical
dietitians are skilled at assessing your nutritional requirements.
9. Psychologists: assess, diagnose, and treat emotional health issues. They help people deal with
illnesses, injuries, and personal crises in their lives. Post-traumatic stress disorder, depression, pain
management, sleep difficulties, adjustment difficulties, anxiety, and feelings of grief and loss are often
treated by psychologists.
10. Occupational Therapists: help patients perform tasks needed for every-day living or working.
They work with patients who have physical, mental or developmental disabilities. This includes stroke
patients who have lost function on one side of their body, heart or lung disease patients with activity
or breathing limitations, or diabetes patients who have had a limb amputated. Occupational therapists
help clients find new ways to dress, cook, eat or work. They may visit patients in their home or
workplace to find adaptive equipment or teach patients new ways to do things.
11. Social workers: in a clinical or hospital setting help patients and families cope with emotional,
physical and financial issues related to an illness. Depending on a patient's need a social worker may
help coordinate services such as housing, transportation, financial assistance, meals, long-term care, or
hospice care. Social workers may also refer patients to mental health professionals for emotional or
substance abuse support. Social workers have a master's degree and are licensed by the state.
12. Spiritual Leaders: Religion or spirituality can be important for people coping with illness.
Members of the clergy such as priests, ministers and rabbis provide patients with spiritual
support. They may listen to patients, counsel them on religious or spiritual philosophy. They may
also perform religious sacraments or rites such as special blessings, communion or last rights.
13. Administrative and clerical staff: coordinate and facilitate patient care. They schedule
appointments, answer phones, greet patients, keep medical records, handle medical billing, fill
out insurance forms, arrange for laboratory or other diagnostic services, and handle financial
records. Some job titles of administrative or clerical staff include: – Clinic Coordinator –
Administrative Medical Assistant – Medical Records Specialist – Medical Billing Specialist –
Financial Counselor – Scheduler
14. Volunteers: are an important part of the healthcare team. The duties of volunteers can
vary widely. Volunteers may have administrative duties and work in reception areas or gift
shops. In a medical office they may file documents, answer phones, help with health screening
or deliver documents to various parts of the hospital. "Advanced Volunteers" have special
training and may work closely patients under the supervision of a nurse or doctor.
C. ROLE OF THE FAMILY IN HEALTH EDUCATION
 Family health - Is part of community health. It is more than the sum of personal health of individual. It is a
unit of health care.
 Role and responsibilities of parent:
 A parent must:
• Protect his/her young from physical harm.
• Provide physical necessities, such as food, water, clothing protection from the ailments.
• Provide emotional necessities.
• Assist with education in preparation for the child to become a productive adult.
• Provide moral guidance so that the child can turn out to be a responsible adult.
 Parenting education
• Parenting education is a course or programmed which is given to raising successful children,
creating competent, confident parents, and building strong families and communities.
• With love, limits, and lots of involvement, parents can have a major influence in developing
happy, healthy and well-behaved children.
• A parent education program is a course that can be followed to correct and improve a persons
parenting skills, such courses may be general, covering the most common issues parents may encounter, or
specific, for infants, toddlers, children and teenager s.
• These courses may also be geared towards parents who are considering having a child, or
adopting one, or are pregnant.
FUTURE DIRECTIONS FOR CLIENT EDUCATION
A. Greater Emphasis on Wellness

B. Increased Third – Party Reimbursement

FILIPINO CULTURAL CHARACTERISTICS AND HEALTH
CARE BELIEFS AND PRACTICES IN HEALTH EDUCATION
 Culture is defined as the “totality of socially transmitted pattern of thoughts, values,
meanings, and beliefs”.
 It is not limited to any specific ethnic group, geographical area, language, religious
belief, manner of clothing, sexual orientation, and socioeconomic status.
 In Revisiting usog, pasma, and kulam explains that “culture is inscribed in our bodies
and in our minds”. As such, the relationship of culture and health is important to
understand as it impacts an individual’s worldview and decision-making process. Like
in other fields of medicine, the impact of cultural beliefs is increasingly being
recognized as an essential component in the genetic counseling process.
 Cultural awareness is a prerequisite prior to achieving cultural competency. It is the
understanding that a cultural divide exists between the patient and health
professional.
FILIPINO WORD DEPICTING CULTURAL
BELIEFS
 Pasma is roughly defined as an “exposure illness” which occurs when a
condition considered to be “hot” is attacked by a “cold” element and
vice versa.
 lihi is a concept used to explain why some children are noted to have
certain specific characteristics. An ethnographic study done in a
municipality in the Philippines referred to lihi as a term for conception,
while some literature referred to it as maternal cravings. During
the lihi period, also referring to the first trimester of pregnancy, the
pregnant woman experiences a number of physical discomforts
including feelings of dizziness, nausea, irritability, and general
weakening of the body. It is also during this time that the pregnant
woman develops intense craving for certain foods and intense liking for
certain objects.
 Sumpa and gaba are beliefs in the Filipino culture pertaining to a curse. In sumpa, the curse is
inflicted by a human being. Like in AS’s case, she is seen as a curse in the family and explains
why they are poor. In contrast, gaba is a curse inflicted by a divine being and it is usually God.
This is inflicted to a person because he/she committed a social sin. Like GV, the medical family
history is noted to have numerous cases of cancer because of the belief that their ancestors were
not giving back to the community. This means that their family is perceived to be “business
sharks” and exploits the less fortunate. Gaba is predominantly a belief of Filipinos in the central
islands of Visayas.
 Beliefs in supernatural beings are widespread in the Philippines. Specifically, namaligno is a
Filipino belief that a disease is caused by an intervention of a supernatural or a mystical being.
A genetic condition which has been associated with having a mystical etiology is Marfan
syndrome. In an informal interview, the respondents verbalized that a person with Marfan
syndrome looked like a kapre, a mythical tree giant of Philippine folklore. A kapre is a dark
giant who likes to smoke huge rolls of cigars and hide within and atop large trees such as an old
acacia and mango trees. A person with Marfan syndrome was said to be born of a mother who
was impregnated by a kapre. The kapre must have been in love with the mother and sneaked
into her bed when the father was out or asleep. Another theory was that the kapre possessed the
husband, thus impregnating the wife with his own physical characteristics, such as long limbs and
hands.
DEVELOPMENTAL STAGES OF THE LEARNER
ACROSS THE LIFESPAN
 Develop mentalists break the life span into nine stages as follows:
 Prenatal Development
 Infancy and Toddlerhood
 Early Childhood
 Middle Childhood
 Adolescence
 Early Adulthood
 Middle Adulthood
 Late Adulthood
 Death and Dying
 Prenatal Development - Conception occurs and development begins. All
of the major structures of the body are forming and the health of the
mother is of primary concern. Understanding nutrition, teratogens (or
environmental factors that can lead to birth defects), and labor and
delivery are primary concerns.
 Infancy and Toddlerhood - The first year and a half to two years of life
are ones of dramatic growth and change. A newborn, with a keen sense of
hearing but very poor vision is transformed into a walking, talking toddler
within a relatively short period of time. Caregivers are also transformed
from someone who manages feeding and sleep schedules to a constantly
moving guide and safety inspector for a mobile, energetic child.
 Early Childhood - Early childhood is also referred to as the preschool
years consisting of the years which follow toddlerhood and precede formal
schooling. As a three to five-year-old, the child is busy learning language,
is gaining a sense of self and greater independence, and is beginning to
learn the workings of the physical world. A toddler’s fierce determination
to do something may give way to a four-year-old’s sense of guilt for doing
something that brings the disapproval of others.
 Middle Childhood - The ages of six through eleven comprise middle
childhood and much of what children experience at this age is
connected to their involvement in the early grades of school. Now the
world becomes one of learning and testing new academic skills and
by assessing one’s abilities and accomplishments by making
comparisons between self and others. Schools compare students and
make these comparisons public through team sports, test scores, and
other forms of recognition.
 Adolescence - Adolescence is a period of dramatic physical change
marked by an overall physical growth spurt and sexual maturation,
known as puberty. It is also a time of cognitive change as the
adolescent begins to think of new possibilities and to consider
abstract concepts such as love, fear, and freedom. Ironically,
adolescents have a sense of invincibility that puts them at greater risk
of dying from accidents or contracting sexually transmitted infections
that can have lifelong consequences.
 Late Adulthood - This period of the life span has increased in the last
100 years, particularly in industrialized countries. Late adulthood is
sometimes subdivided into two or three categories such as the “young
old” and “old old” or the “young old”, “old old”, and “oldest old”. A
better way to appreciate the diversity of people in late adulthood is
to go beyond chronological age and examine whether a person is
experiencing optimal aging (like the gentleman pictured above who is
in very good health for his age and continues to have an active,
stimulating life), normal aging (in which the changes are similar to most
of those of the same age), or impaired aging (referring to someone
who has more physical challenge and disease than others of the same
age).
Death and Dying - there is a certain discomfort in thinking about
death but there is also a certain confidence and acceptance that can
come from studying death and dying. We will be examining the
physical, psychological and social aspects of death, exploring grief or
bereavement, and addressing ways in which helping professionals
work in death and dying. And we will discuss cultural variations in
mourning, burial, and grief.
PRINCIPLES OF TEACHING AND
LEARNING
view health as more than the absence of disease
utilize all educational opportunities for health: formal and informal,
traditional and alternative; inside and outside the school and community.
 harmonize all of the health messages
 empower students to act for healthy living and to promote conditions
supportive of health
 establish a basis for lifelong learning and promotion of health
foster interaction between schools, the community, parents and local services
ensure a healthy school environment or community
 14 PRINCIPLES OF EFFECTIVE LEARNING IN
HEALTH EDUCATION
1. Interest: Health education must be imported in a interesting manner. Learning only takes
place when one is interested method like explaining example of current events creates
interest.
2. Readiness of learner: Learner must feel comfortable and willing to participate in school
healthy programs. Therefore proper motivation and interest should be aroused in students.
3. Positive manner: In health education, positive statements like Be Clean area preferable,
there should not be negative statements like do not remain dirty, positive statements are
effective and workable than negative statements.
4. Practical knowledge: Health education is better understood if imparted in practical
situations. Practically experiencing healthy programs develop more interest and learning.
5. Classification of healthy education: Subject matter imparted in healthy education must
be classified according to the age group. Topic suitable for higher secondary students may
be very difficult for elementary students like Topic on Aids, Cancer etc.
6. Better communication: Language used must be easy and understandable so that
better communication will take place and students can easily make their doubts clear.
7. Based on need of the hour: Health education must cover the most required topics.
Health programmed running under school organization therefore mainly includes topics
like personal hygiene, communicable disease, first/aid. School health education
programs mainly concern about childhood and adolescent needs.
8. Teaching Aids: Utilization of teaching aids like audio/visual adds or illustrative
materials in explanations lead to better and interesting learning in students. Showing
films or photographs with message of health importance are preferable.
9. Individual Attention: Sometimes situation may not permit to adopt health habits
quickly, therefore effective health educational process will only take place when
individual attention and reasonable time is given to the same person. Punishment must
not be given to students if one is unable to adopt health education practically.
10. No competitive spirit: Health education is against the competitive spirit. No two
individuals could be alike in posture and no single posture is said to be best. Therefore,
there should not be any kind of competitive spirit, this may lead to unhealthy
competition and use of unfair means.
11. Motivation: Providing motivation is the most necessary part of health education,
for practicing health programs in life style.
12. Health Education is a collective effort: It is duty of every individual to contribute
in the health of community. Not only physical teachers, every general teacher and
student are involved in the health educational guidance and counseling programs.
13. Systematic and Continues efforts: Systematic and continues health programs are
more beneficial than unsystematic and non-continuous programs. To produce desirable
education what benefits they are gaining etc., are the quarries need to be properly
checked for betterment of the health education system if needed.
14. Socially Accepted: In many education institutions, health education includes the
knowledge of ‘sex education’ and many times it was protested by some people as they
declare this topic ‘non-educational’. Topics like causes of Aids, Hepatitis-B are equally
essential, rather more important. Therefore in a cooperative manner, health educator
need to progress in imparting knowledge on such topics.
 HEALTH EDUCATION PROCESS
A. Assessing the Learner
 Learning is relatively a change in mental processing, emotional functioning, and/or behavior as
result of experience. Educator’s role in learning is primarily to assess the learner in relation to
the three factors that affect learning.
1. Determinants of Learning
 Learning Needs are gaps of knowledge that exist between a desired level of performance
and the actual level of performance. A gap between what someone knows and what someone
needs to know due to lack of knowledge, attitudes or skills.
 Methods of Assessing Learning Needs
1. Informal Conversations or Interviews - An interview is a conversation
between two or more people where questions are asked by the interviewer to obtain
information from the interviewee.
2. Structured Interviews - The aim of this approach is to ensure that each
interview is presented with exactly the same questions in the same order.
3. Written Pretests - Can be given to identify the knowledge level of thepotential
learner and to help in evaluating whether the learner has taken place by comparing
pretest with post-test scores.
4. Observations - Observation is either an activity of a living being (such as a
human), consisting of receiving knowledge of the outside world through the senses, or the
recording of data using scientific instruments.
 STEPS IN ASSESSING LEARNING NEEDS
Identify the Learner - Who is the learner?
Choose the Right Setting - Establish a trusting environment.
Collect Data on the Learner - Determine the characteristics of learning needs of the
target population, patient, or any recipient of the learning material.
Include the Learner as a Source of Information - Allow the learner to actively
participate in the learning process.
Include Members of the Healthcare Team - Collaborate with the members of
healthcare professionals who may have insights or knowledge of the patient or learner.
Determine Availability of Educational Resources - Use materials and equipment to
help in the learning process.
Assess Demands of the Organization - Examine the organizational situation; its
philosophy, vision, mission, and goals to know what its educational focus is.
CONT. . .
Consider time-management issues - allow learners to
identify their learning needs; identify potential
opportunities to assess the patient anytime, anywhere;
and minimize distractions/interruptions during planned
interviews.
Prioritize needs - This may be based on Maslow’s
hierarchy of needs where the basic lower level
physiologic needs must first be met before one can
move up to the higher, more abstract level of needs.
MASLOW’S HIERARCHY OF NEEDS IN
RELATION TO NEEDS ASSESSMENT
Self actualization - Recognition and realization of one’s potential, growth, health
and autonomy
Self-esteem needs - Sense of self-worth, self-respect, independence, dignity,
privacy and self-reliance
Love and belongingness needs - Affiliation, affection, intimacy, support
reassurance
Safety and security needs - Safety from physiologic and psychological threats,
protection, stability
Physiological needs - Oxygen, food, elimination, temperature control, sex,
movement, rest, comfort
 THE CRITERIA FOR PRIORITIZING LEARNING
NEEDS(HEALTHCARE EDUCATION
ASSOCIATION, 1985)ARE:
A. Mandatory - learning needs that must be immediately met since they are life threatening
or are needed for survival.
Ex. a person with an impending heart attack should be taught of the signs and
symptoms and emergency measures or what medicines to take to be prepared/stop the
occurrence.
B. Desirable - learning needs that must be met to promote well-being and are not life-
dependent.
Ex. patient with pulmonary tuberculosis should understand the importance of taking
the medicines regularly until the regimen ends to be totally cured.
C. Possible - nice to know´ learning needs which are not
directly related to daily activities.
Ex.an obese patient who just lost weight because of
her diabetes may not necessarily need information on
³tummy tucking´ as a surgical or aesthetic procedure to
remove sagging abdominal muscles. Her main concern is
Diabetes Mellitus.
 READINESS TO LEARN
When assessing readiness to learn, the health educator must:
1. determine what needs to be taught
2. find out exactly when the learner is ready to learn
3. discover what the patient wants to learn
4. identify what is required of the learner: (a.) what needs to be learned (b.) what the
learning objectives should be (c.) find out in which domain of learning and at what level
the lesson will be taught
5. determine if the timing (the point at which the nurse will conduct teaching) is right or
proper
6. find out if the rapport or interpersonal relationship with the learner has been
established (Hussey & Hirsch,1983)
7. determine if the learner is showing signs of motivation
8. assess if the plan for teaching matches the development level of the learner
FOUR TYPES OF READINESS TO
LEARN(PEEK)
P=Physical Readiness
1. Measure of ability - adequate strength, flexibility and endurance is
needed to teach a patient how to walk on crutches and for him/her to
be ready to learn while measures requiring visual and auditory acuity a
patient also affect the learning readiness especially if the senses of
sight and hearing are impaired.
2. Complexity of task - the difficulty level of the subject or the task to be
mastered; psychomotor skills require varying degrees of manual
dexterity and physical energy output but once acquired or mastered;
they are usually retained better and longer than learning in the
cognitive and affective domains.
4. Health status - Is the patient in a state of good health
or ill health? Does he still have the energy or motivation to
learn?
5. Gender - studies show that men are less inclined to seek
health consultation or intervention than women. Women, on
the other hand, are more health conscious and receptive to
medical care and health promotion teaching (Bertakis et
al., 2000).
E=EMOTIONAL READINESS
Anxiety level = may or may not be a hindrance to learning. Some
degree of anxiety may motivate a person to learn but high or low
degree of anxiety will interfere with readiness to learn.
Support system = a strong support system composed of the
immediate family and friends, significant others, the community and
church will give the patient increased sense of security and well-
being while a weak or absent support system elicits sense
of insecurity, despair, frustration and high level of anxiety.
Motivation = is strongly associated with emotional readiness or
willingness to learn.
Risk-taking behavior = are activities that are under taken without
much thought to what their negative consequence or effects might
be.
Frame of mind = depends on what the priorities of the learner
are in terms of his needs which will determine his readiness to
learn.‡
Development stage = determines the peak time for readiness to
learn or teachable moment´ (Tanner,1989, Hansen & Fisher, 1998).
E = EXPERIENTIAL READINESS
Experiential readiness refers to the previous learning experiences which
may positively (if the experience is pleasant and appropriately
reinforced) or negatively (if the learning experience has been
unsatisfying, humiliating or frustrating) affect willingness to learn.
1. Level of aspiration = depends on the short-term and long-term goals
that the learner has set which will influence his motivation to achieve.
2. Past coping mechanism = refer to how the learner was able to cope
with or handle previous problems or situations and how effective were
the strategies used.
3. Cultured background = is important to assess and know from the
patient’s own cultural perspective in order to determine readiness to
learn.
a. Awareness of the culture of the learner is of prime important.
Knowledge of the concepts of transcultural nursing will be a great help.
b. Find out also if the patient understands the language that is
being used to communicate with him.
4. Locus of control = refers to motivation to learn which maybe.
a. Internal locus of control or intrinsic (within the individual as
he/she is driven by the desire to know or learn), or
b. External locus of control or extrinsic ( motivation to learn is
influence by others who encourage the learner to learn )
 5. Orientation = this refers to a person’s point-of-view
which maybe:
a. Parochial = close-minded thinking, can conservative
in their approach to new situations, less willing to learn new
materials and have a great trust in the physicians.
b. Cosmopolitan orientation = Is a more worldly
respective perspective and more receptive to new or
innovative ideas like the current trends and perspectives in
health education.
K = KNOWLEDGE READINESS

Knowledge Readiness refers to:

1. Present knowledge base - also referred to a stock
knowledge or how much one already knows above the subject matter
from previous actual or vicarious learning.
2. Cognitive ability - involve lower level of learning which
includes memorizing, recalling or recognizing concepts and ideas the
extent to which this information is process indicates the level at which
the learner is capable of learning
B. DEVELOPING A HEALTH EDUCATION PLAN
Elements
1. Manage The Planning Process - develop a plan to
manage stakeholder participation, timelines, resources, and
determine methods for data-gathering, interpretation, and decision
making. Plan how you will allocate financial, material, and human
resources. Consider the data required to make decisions at each
step and include adequate time for data collection and
interpretation. Establish a clear decision‐making process. (e.g., by
consensus, by committee)
 2. Conduct A Situational Assessment - learn more about the population of
interest, trends, and issues that may affect implementation, including the wants, needs,
and assets of the community. This involves identifying: what is the situation; what is
making the situation better and what is making it worse; and what possible actions you
can take to address the situation.
3. Identify Goals, Populations Of Interest, Outcomes And Outcome
Objectives - use situational assessment results to determine goals, populations of
interest, outcomes and outcome objectives. Ensure program goals, populations of
interest and outcome objectives are aligned with strategic directions of your
organization or group:
 Goal: a broad statement providing overall direction for a program over a long
period of time.
 Population(s) Of Interest : group or groups that require special attention to
achieve your goal
 Outcome Objective: brief statement specifying the desired change caused by the
program
 4. Identify Strategies, Activities, Outputs, Process Objectives And Resources - use
the results of the situational assessment to select strategies and activities, feasible with
available resources, that will contribute to your goals and outcome objectives. Brainstorm
strategies (e.g. health education, health communication, organizational change, policy
development) for achieving objectives using one or more health promotion frameworks such
as the Ottawa Charter for Health Promotion or the socioecological model. Prioritize ideas
by applying situational assessment results.
5. Develop Indicators - develop a list of variables that can be tracked to assess the
extent to which outcome and process objectives have been met. For each outcome and
process objective consider the intended result and whether: the intended result can be
divided into separate components; the intended result can be measured; there is
appropriate time for observing a result; required data sources are accessible; and the
resources needed to assess the result are available.
 6. Review The Program Plan - clarify the contribution of each component of
the plan to its objectives, identify gaps, ensure adequate resources, and ensure
consistency with the situational assessment findings. A logic model is a graphic
depiction of the relationship between all parts of a program (i.e., goals, objectives,
populations, strategies, and activities) and is one way in which a program overview
can be communicated.
OBJECTIVES
1. Health objectives - Describe how health status is to be improved. They are termed as
“outcome objective”. They are ends/represent the true bottom line of the program
E.g To reduce infant mortality by 2/3rd by the end of 2015 17By:AT (MPH)
2. Behavioral objectives - refers to the actual things the program will encourage people to
do or not to do!
E.g To reduce cigarette smokers by 50%
3. Learning objectives - describe knowledge, attitude or skill development
E.g Clients should able to describe three ways of HIV/AIDS transmission
4. Resource objective - Is what the program planners hope to provide , be it the essential
service or material support
E.g To establish three counseling center by the end of 2012
To supply 3000 poster for each health center by the end of 2012.
To distribute 10,000 hagober at the end of 2013
C. STRATEGIES AND METHODOLOGIES
Develop plan of work - A plan of work is a detailed schedule of activities to be done
in a given period of time. It should specify the role of different persons involved, the
time in which the particular activities have to be carried out, and the different methods
to be used.
Work plan - an action plan should answer the following questions.
1. When should it start and when should it be completed?
2. Who does it?
3. Who is responsible for seeing it is actually carried out?
4. What materials and resources are needed?
IMPLEMENTATION OF THE PROGRAMS
Implementation is carrying out the plan or putting
the plan/program into action. It is translating the
goals, objectives and methods into a community
based health education programs.
 Monitoring is the systematic collection and analysis of information on the
project progress. It helps to keep the work on track. Enables the planners to
detect any kind of problems related to the performance of the activities as
early as possible and to give relevant solutions to the problems detected.
EVALUATION
the process of assessing whether the health education interventions are attaining their
goals and objectives which are predetermined while planning the interventions.
That answers the following:
1. Effectiveness?
2. Efficiency ?
Type of Evaluation Description
 Focuses on programs that are under development
 Used in the planning stages of a program to ensure
program is based on stakeholders’ needs and is
using effective and appropriate materials and
procedures
 A situational assessment is a critical formative
Formative evaluation evaluation activity
 Focuses on programs that are already underway
 Examines the procedures and tasks involved in
providing a program
 Answers “what services are actually being delivered
Process evaluation and to whom?”
 Focuses on programs that are already underway or
completed
 Investigates the effects of the program, both
intended and unintended
 Answers, “What difference did the program make?”
(impact evaluation) and, “Which stated goals and
objectives were met?” (outcome evaluation)
 Summative evaluations can assess short-term
Summative evaluation outcomes and long-term outcomes
Examples of what it evaluates
 Situational assessments
 Creating program logic models
 Pre-testing of program materials
 Audience analysis.
 Tracking the quantity and descriptors of people who
are reached by the program
 Tracking the quantity and types of services
provided and descriptions of what actually occurred
while providing services
 Changes in attitudes, knowledge or behavior;
 Changes in morbidity or mortality rates;
 Cost-benefit analysis;
 Cost-effectiveness analysis
 Changes in policies
 Impact assessments
THANK YOU!!