Community Health Education Intervention - Term Paper Example

?Community Health Education Introduction According the WHO , health education is defined as the combination of learning experiences that are devised to assist individuals and entire communities to promote their health, both by improving their knowledge regarding health as well as causing a change in their attitudes. In the contemporary era, health education has transcended to the level of a social science which draws from a number of other sciences ranging from medical and physical to environmental, biological and psychological sciences. The aim of health education is to not only increase the knowledge of the people, but also to decrease the incidence of the disease, disability and premature death via activities that are education-driven and targeted at voluntary changes in behavior (CNHEO 2011). The principle behind providing knowledge regarding heath is to bring about positive changes in the health behavior of both specific groups of people and communities, along with aligning their working conditions and lifestyles to healthy and positive practices. Health education is very important for the success and well being of the society. Many countries in the world have an effective and strong health care and health education system. However, problems still arise as a result of the mismanagement or poor organization of the system. Therefore it is important to not only identify these problems but to take steps to eradicate them so that a good and effective health education system can be established. This paper looks into the health-education related problem that I have come across with in my own community. With regard to that, the paper looks into the various aspects of the deficiency, identifying the extent of the problem, as well as providing innovative interventions to it. The paper also reviews the theoretical approaches and models of health promotion and how they can be used in the intervention process. The Health Education Problem It has been seen that many obstacles that arise in the dissemination of health information are a result of poor design and planning. The obstacles thus come to influence the effective implementation of the various aspects of the health education process and its various components, ranging from formative, political and economic problems. In my community, one of the major obstacles that I have seen regarding health education has been the delivery of sex education. One of the most important reasons that can be attributed to poor sex education is limitation in curriculums. This has created a lot of problems for the teachers who have been assigned the role of promoting health awareness amongst the population, particularly the youth. Although education related to sexuality is being imparted since some time now, and AIDS and other sexually transmitted diseases have made the need for health education even more acute, there are still impediments in its delivery. These obstacles not only prove to be a barrier in the development of the plan but also prevent the effective implementation of the health education initiative. As a result, the aims of the initiative fall short and the plan fails to achieve its objectives. Gilbert, Sawyer and McNeill (2009) report that one in every five sex education teacher have problems in the curriculum that they are provided. There are also other problems in the delivery of sex education such as opposition from the parents of the children that the education is aimed at, or by the community as a whole, and lack of support by the higher authorities. There are various issues that arise as a result of poorly planned or inadequate curriculums. Some of the aspects of the programs being followed by health educators are abstinence curricula. In 1981, the American Family Life Act was put into effect. The Act developed Title XX funds which were aimed to devise sexuality programs that were based on the promotion of abstinence in order to holdup the beginning of the sexual activity of the youth. A number of abstinence-until-marriage programs have been developed such as Sex Respect, Success Express and An Alternative National Curriculum ob Responsibility. Although the belief of some educators is that abstinence curricula works and leads to a decrease in the sexual activities of the target population, research studies conducted do not buttress this notion (Gilbert, Sawyer & McNeill 2009). Therefore, the curriculum which is suggestive of such a notion does not provide a comprehensive and effective tool for the provision of health education. The promotion of abstinence-based sexuality by sexual education does not turn out to be very feasible. The curriculums have focused on the delaying the onset of sexual activity by encouraging people to abstain from sex. However the results of studies conducted on the effects of such program do not provide any supporting evidence. In one such study, the programs, such as Sex Respect, which promoted abstinence-until-marriage approaches, did not have any major effect on the target population. The participants of the study, who had taken part in such programs a year or two ago, did not show any noteworthy decrease in their sexual activity. Another study conducted in 1997 adhered to similar findings that the abstinence curricula do not have any important and major influence on the onset of intercourse. The most conclusive and rigorous study has been carried out by Mathematica in 2007 regarding abstinence programs (Newton 2010). The study came to the conclusion that giving people information regarding abstinence and expecting them to practice abstinence till their marriage does not have any influence on their sexual activities (Gilbert, Sawyer & McNeill 2009). From this, it can be established that one of the problems that are associated with abstinence-only programs is that they are not effective, and educators who are providing them are unable to achieve the required objective. However the problem is not resolved if abstinence plus programs are followed either. When abstinence plus programs are mixed with curricula that provide information regarding the use of contraceptives and skills building, i.e. abstinence plus, the target group gets a mixed message (Gilbert, Sawyer & McNeill 2009). Most of the targeted individuals therefore show increased sexual activities. However in studies of abstinence plus programs, students which were surveyed a year or two after their participation in the programs showed abstinence longer as compared to the students in the control group. Such programs include Postponing Sexual Involvement, Skills for Life, and Reducing the Risk. This is representative of the mixed signals that the target population is getting, as a result of inaccurately defined terminologies and lack of coherence in the programs. With obstacles like these present in the provision of effective sex education, it is justifiable for some of the critics to say that sex education does not work. This follows that there is a need to improve the current system of sex education and to make its curricula more effective and comprehensive. Before discussing interventions to the problem, the paper looks into the various heath related theoretical perspectives and health promotions models, so that the interventions can be introduced more effectively. Health Promotion Models There are a range of health promotion and education theories and models. These models and theories strengthen the contemporary health system. However there is a difference between theories and models. Where theories are series of proposals that function to provide explanation for a certain phenomenon, a model is a subclass of theories and does not aim to represent the underlying processes but merely to be a means of representation for them (US Department of Health and Human Services 2005). Examples of models include the Health Belief Model and Transtheoretical Model; theories include Social Cognitive Theory and Theory of Planned Behaviour. Taking the health belief model as an example, it aims to account for the particular health behavior and to implement health behavior change with the individual as the focal point. The health belief model enables the educators to identify the individual’s perception of threat and to encourage the recommended behaviors for averting or handling the problem (US Department of Health and Human Services 2005). Social theory promotes the notion that relationships, interactions and group dynamics have an important role in the learning process of the individual. People are able to interact and learn from each other better in a social context and these interactions encompass both imitation and modeling. The theory provides that environment has an effect on behavior but behavior also influences the environment (Ende 2010). From this it can be followed that the curricula of the sex education must be devised in such a way that it addresses the concern of the individuals regarding the health threat. Moreover effective implementation of the curricula requires that the tone and emotional context in which the education is delivered is not only conducive to but also encourage change. Interventions When designing and formulating various aspects of the sex education curricula, sex educators should understand the importance of developing comprehensive curricula based on its effectiveness as established by research studies. Sex educators should not set goals that are not realistic. Since opponents are of the perspective that sex education does not yield nay positive results, and the abstinence-only and abstinence-plus programs have also failed to be completely effective, it is necessary that when educators formulate the curricula, they should observe great prudence. Care must be taken to avoid incorporating unrealistic behavior objectives in the curricula. Gilbert, Sawyer and McNeill (2009) observe that goals that are not only broad and generalized but also long-term should be designed for the purpose of reducing the rates of teenage pregnancy and increasing the usage of condoms. On the other hand, when the objective is related to specific behavioral change, it should be measurable and be more rational, practical and achievable (Lundy & Janes 2009). Moreover objectives that relate to the increase in the knowledge of the people are also appropriate but sex educators should be scrupulous enough to appreciate that the objectives should not promise anything that the curriculum cannot deliver. Sex education is a field that is put under scrutiny all the time. Amidst opposition to the initiatives, it is important that procedures are incorporated which produce the least numbers of complaints and take into account the standards of the environment in which the educators are working. One way of coming up with an effective curricula is to conduct a needs assessment. Needs assessment is the process of collecting information regarding an organizational need that can be fulfilled by carrying out training. The need can be meant to improve the current performance of the organization or to provide solutions to a deficit, considered as a performance that prevents the organization from achieving its objectives. This is also representative of the fact that there is a perfect way of doing something, and divergence from it is giving rise to problems (Barbazette 2006). Another essential element that must be taken into account is the adequate representation of the community standards and involvement of the community (Page & Page 2010); this is the key for the success of the program. One of the popularly used methods in the development of the curriculum is the formation of a two-committee system. The importance of the two-committee system is that it makes use of two committees. The first committee is the writing committee and compromises professionals who are given the responsibility of writing the curriculum. On the other hand, the nature of the second committee is advisory. This advisory committee is designated the role of guiding the first committee and providing it feedback regarding the curriculum it drafted before it is finalized and implemented (Gilbert, Sawyer & McNeill 2009). The writing committee should be made up of professionals who do not only have know-how of sex education but also come from the area or institution that is the target of the program. The size of the committee must be given due attention, since too small committees might not be a fair representation of the targeted population. In order to make the implementation of the program more effective, the peer leaders or teachers who are meant to deliver the course should be motivated and must show faith and interest in the plan. The sex educators should provide them with effective training to equip them with the necessary knowledge and teaching skills. Moreover to make the program long-range, it should be of a sufficient span of time and should not be one-off or consisting of several interventions which last only for a few hours (Gilbert, Sawyer & McNeill 2009). Moreover it is also important to assess and evaluate the effectiveness of the program after it has been introduced. Evaluation is an ongoing process and refers to the systematic collection of data regarding activities, properties and results of the program to establish the effectiveness of the program and improve any shortcomings (Hodges & Videto 2010). There are several different types of evaluations including formative, summative, process, efficiency, impact and outcome. Conclusion Summing up the discussion, it can be said that curricula of the health education program is very important in the effective implementation of the program and for the achievement of productive outcomes. Failing to do so, as in the case of abstinence-only and abstinence plus programs not only negates the purpose of the program but also affects the stakeholders, i.e. the target population; such programs fail to bring about voluntary behavior changes in the population such as to promote healthy sex behavior. There is a need to develop comprehensive sex education programs since research has shown that they are more effective than abstinence-only education (Anon 2010). The designing of the curricula can be done by first performing a needs assessment and then designating two committees, the writing and the advisory, to draft the curricula. To make the program wholly effective, evaluation must be carried out. All the health education activities are for nothing if the target population does not receive any benefit from it in some substantial, measurable way (Miller & Stoeckel 2010). References Anon 2010, Sex and Society, Volume 3, Marshall Cavendish. Barbazette, J 2006, Training needs assessment: methods, tools, and techniques, Volume 1, John Wiley and Sons. CNHEO 2011, What is Health Education, Coalition of National Health Education Organizations, viewed on 10 February, 2011, Ende, J 2010, Theory and Practice of Teaching Medicine, ACP Press. Gilbert, GG, Sawyer, RG & McNeill, EB 2009, Health Education: Creating Strategies for School and Community Health, 3rd edn, Jones & Bartlett Learning. Hodges, BC & Videto, DM 2010, Assessment and Planning in Health Programs, 2nd edn, Jones & Bartlett Learning. Lundy, KS & Janes, S 2009, Community health nursing: caring for the public's health, Jones & Bartlett Learning. Miller, MA & Stoeckel, PR 2010, Client Education: Theory and Practice, 2nd edn, Jones & Bartlett Learning. Newton, DE 2010, Sexual health: a reference handbook, ABC-CLIO. Page, RM & Page, TS 2010, Promoting Health and Emotional Well-Being in Your Classroom, 5th edn, Promoting Health and Emotional Well-Being in Your Classroom. US Department of Health and Human Services 2005, Theory at a glance. A guide for health promotion practice, 2nd edn, National Institutes of Health. WHO 2011, Health Education, World Health Education, viewed on 10 February, 2011, Read More