Health Education: Approaches and Methods

Health Education Methods to various class of audience. pros and cons of various methods at individual, group and mass level. Good topic specially for first year medical students for learning how to communicate and also from exam point of view. Its is good for short notes as well in viva voce. Many MCQs are seen in PG entrance exams also. so give time to this topic and discuss among peers.

1. Prof. Dr. Neha Upadhyai

2. HEALTH EDUCATION

3. PRINCIPLES OF HEALTH EDUCATION CIP Can Make Real Learning, Keeping Examples, Giving Feedback, and Leading

4. CREDIBILITY It is the degree to which the message to be communicated is perceived as trustworthy by the receiver. Good health education must be consistent and compatible with scientific knowledge and also with the local culture, education system and social goals. Unless the people have trust and confidence in the communicator, no desired action will result after receiving the message.

5. INTEREST People are unlikely to listen to those things which are not to their interest. Health educators must find out the real health needs of the people. These are called "felt-needs", that is needs the people feel about themselves. If a health program is based on "felt needs" people will gladly participate in the program; and only then it will be a people's program. Sometimes people are not aware of their needs, in that case, t he health educator will have to bring about a recognition of the needs before he proceeds to tackle them.

6. PARTICIPATION Participation is a key word in health education. It is based on the principle of active learning. Participation of family members in patient care will create opportunity for more effective, practically based health education. If community participation is not an integral part, health programs are unlikely to succeed "

7. MOTIVATION In every person, there is a fundamental desire to learn and awakening this desire is called motivation. There are two types of motives - primary and secondary. Primary motives (e.g. hunger, survival) are driving forces initiating people into action; these motives are inborn desires. Secondary motives are based on desires created by outside forces or incentives e.g. praise, love, rivalry, rewards and punishment, and recognition. In health education, motivation is an important factor; that is, the need for incentives is a first step in learning to change. The incentives may be positive (the carrot) or negative (the stick).

8. COMPREHENSION In health education we must know the level of understanding, education and literacy of people to whom the teaching is directed. One barrier to communication is, using words which cannot be understood. E.g. starchy food in diabetics, teaspoon to a villager, BD/TDS In health education, we should always communicate in the language people understand Teaching should be within the mental capacity of the audience.

9. REINFORCEMENT Repetition at intervals is necessary. If there is no reinforcement, there is every possibility of the individual going back to the pre-awareness stage. If the message is repeated in different ways, people are more likely to remember it.

10. LEARNING BY DOING Learning is an action - process; not a "memorizing" one in the narrow sense. The Chinese proverb: "If I hear, I forget; if I see, I remember; if I do, I know" illustrates the importance of learning by doing.

11. KNOWN TO UNKNOWN In health education work, w e start where the people are and with what they understand and then proceed to new knowledge. New knowledge will bring about a new understanding For Example - health educator starts by discussing a familiar subject like "the importance of drinking adequate amount of water" and then moves on to the less familiar topic of "how dehydration affects brain function."

12. SETTING AN EXAMPLE The health educator should set a good example in the things he is teaching. If he is explaining the hazards of smoking, he will not be very successful if he himself smokes.

13. GOOD HUMAN RELATIONS A community health worker listens attentively to individuals' health concerns without judgement, fostering trust and building a positive relationship with the community, making them more receptive to health advice. Building good relationship with people goes hand in hand with developing communication skills.

14. FEEDBACK Feedback is one of the key concepts of the systems approach. The health educator can modify the elements of the system (e.g., message, channels) in the light of feedback from his audience. For effective communication, feedback is of paramount importance.

15. LEADER W e learn best from people whom we respect and regard. In the work of health education, we try to enter the community through the local leaders - the village headman, the school teacher or the political worker. Leaders are agents of change and they can be made use of in health education work. If the leaders are convinced first about a given program, the rest of the task of implementing the program will be easy.

16. PRACTICE OF HEALTH EDUCATION This consists of Audio-visual Aids and Methods of health education

17. AUDIOVISUAL AIDS

18. AUDIO-VISUAL AIDS :TYPES AUDITORY AIDS - Radio, tape-recorder, microphones, amplifiers, earphones. VISUAL AIDS – (a) Not requiring projection : Chalk-board, posters, charts, flannelgraph, exhibits, specimens, leaflets, models museum etc. (b) Requiring projection: Slides, film strips, Transparencies with OHP (3) COMBINED A - V AIDS - Television, sound films (Cinema), slide - tape combination.

19. LEVELS IN HEALTH EDUCATION

20. METHODS IN HEALTH EDUCATION

21. INDIVIDUAL APPROACH e.g. Personal interviews , OPD consultation Patient can be counselled on causation, nature of illness and its prevention, personal hygiene, environmental hygiene, diet etc. The biggest advantage of individual health teaching is that we can discuss, argue and persuade the individual to change his behavior. It provides opportunities to ask questions in terms of specific interests. The limitation of individual health teaching is that the numbers we reach are small, and health education is given only to those who come in contact with us.

22. GROUP APPROACH The groups can be school children, expectant mothers, industrial workers etc. There are two broad methods: Didactic Method- one way method. Giving information without discussion between the audience and the speaker. Socratic Method: two way method. Both communicator and the audience take part. e.g. interviews, demonstration.

23. MASS APPROACH - EDUCATION OF THE GENERAL PUBLIC No health worker or health team can mount an effective health education program for the whole community, except through mass media of communication Mass media are a "one-way" communication. The number of people who are reached usually count in millions. Their effectiveness can give high returns for the time and money involved.

24. MASS APPROACH Used to address general public. Important value in reaching large numbers of people with whom there is no contact in a short period of time. They are useful in transmitting messages to people even in the remotest places. Examples: TV, Radio, Internet (social media), news paper, printed materials, posters billboards, health museums, exhibitions, and folk media, Health Magazines Mass media alone are generally inadequate in changing human behaviour. For effective health communication, they should be used in combination with other methods.

25. CHALK AND TALK (LECTURE) Carefully prepared oral presentation of facts, organized thoughts and ideas by a qualified person. The "chalk" lends the visual component. The talk should be based on a topic of current interest or health needs of the group. Can be made interactive and interesting by the use other AV aids.

26. CRITERIA OF GOOD LECTURE Topic is to be informed well in advance Ideal time is morning No. of participants should not be more than 30 Duration of lecture should not be >40 min. Topic should be divided in to sub headings Should summarise at the end.

27. CHALK AND TALK -DISADVANTAGES Students’ involvement is less Learning is passive; Do not stimulate thinking or problem-solving capacity; The comprehension of a lecture varies with the student; The health behaviour of the listeners is not necessarily affected.

28. FLIP CHART This consists of series of charts or posters, each of about 25×30 cm, each with an illustration pertaining to the talk. Each chart is shown before the group and talk is given. It is then flipped and shown the next chart. These charts hold the attention of the group. Message of the chart should be brief and to the point

29. PFLANNEL GRAPH This consists of a Khadi cloth fixed over a wooden board It provides a good background for displaying pictures, cutouts, drawings etc. in sequence to maintain continuity It is simple and easy to transport. Good for informal talks or covering simple topics.

30. DEMONSTRATION It is a carefully prepared presentation to show how to perform a skill or procedure. Here a procedure (e.g. preparation of ORS, disinfection of a well) is carried out step by step before an audience or the target group, the demonstrator ascertaining that the audience understands how to perform it by involving the audience in discussion. It upholds the principle of learning by doing. The clinical teaching in hospitals is based on demonstrations. This method has a high motivational value

31. GROUP DISCUSSION A "group" here is an "aggregation of people interacting face to face" For effective group discussion, the group should comprise not less than 6 and not more than 12 members. The participants are all seated in a circle, so that each is fully visible to all the others

32. GROUP DISCUSSION There should be a group leader who initiates the subject, helps the discussion in the proper manner, prevents side-conversations, encourages everyone to participate and sums up the discussion in the end. If the discussion goes well, the group may arrive at decisions which no individual member would have been able to make alone. It is also desirable to have a person to record whatever is discussed. The "recorder" prepares a report on the issues discussed and agreements reached.

33. RULES OF GROUP DISCUSSION The members of the group should follow the following rules: (a) express ideas clearly and concisely (b) listen to what others say (c) do not interrupt when others are speaking (d) make only relevant remarks (e) accept criticism gracefully and (f) help to reach conclusions (9) Group discussion is successful if the members know each other beforehand, when they can discuss freely.

34. Limitations There may be unequal participation of members in a group discussion, unless properly guided. Those who are shy may not take part in the discussions. Some may dominate the discussion Some members may deviate from the subject and make the discussion irrelevant or unprofitable

35. PANEL DISCUSSION In a panel discussion, 4 to 8 persons who are qualified to talk about the topic sit and discuss a given problem, or the topic, in front of a large group or audience. The panel comprises, a chairman or moderator and from 4 to 8 speakers. The chairman opens the meeting, welcomes the group and introduces the panel speakers. He introduces the topic briefly and invites the panel speakers to present their points of view. There is no specific agenda, no order of speaking and no set speeches The success of the panel depends upon the chairman; he has to keep the discussion going and develop the train of thought.

36. PANEL DISCUSSION CONTD…. After the main aspects of the subject are explored by the panel speakers, the audience is invited to take part. The discussion should be spontaneous and natural. If members of the panel are unacquainted with this method, they may have a preliminary meeting, prepare the material on the subject and decide upon the method and plan of presentation.

37. SYMPOSIUM A symposium is a series of speeches on a selected subject. Each person or expert presents an aspect of the subject briefly. There is no discussion among the symposium members like in panel discussion. In the end, the audience may raise questions. The chairman makes a comprehensive summary at the end of the entire session.

38. SEMINAR In this method, one expert will speak about different components of the same subject to a group having a common interest or discipline These are usually conducted in academic or research institutions Preliminary planning is needed. It requires effort and time for preparation

39. WORKSHOP It consists of a series of meetings, usually four or more, with emphasis on individual work, within the group, with the 'help of consultants and resource personnel. The total workshop may be divided into small groups and each group will choose a chairman and a recorder. The individuals work, solve a part of the problem through their personal effort with the help of consultants, contribute to group work and group discussion and leave the workshop with a plan of action on the problem. Learning takes place in a friendly, happy and democratic atmosphere, under expert guidance. The workshop provides each participant opportunities to improve his effectiveness as a professional worker.

40. ROLE PLAYING Role playing or socio-drama is based on the assumption that many values in a situation cannot be expressed in words, and the communication can be more effective if the situation is dramatised by the group. The group members who take part in the socio-drama enact their roles The audience feels connected to the role play and pay sympathetic attention to what is going on The size of the group is thought to be best at about 25. Role playing is a useful technique to use in providing discussion of problems of human relationship. It is a particularly useful educational device for school children and village people. Role playing is followed by a discussion of the problem.

41. CONFERENCES This category contains a large component of commercialized continuing education. The programs are usually held on a regional, state or national level. They range from once half-day to one week in length and may cover a single topic in depth or be broadly comprehensive. They usually use a variety of formats to aid the learning process from self instruction to multi-media

42. THANK YOU

43. All the best for your upcoming exams! Do Well!