Primary Level of Prevention

preventive measures that forestall the onset of illness or injury during the pre-pathogenesis period.

*ex: vaccinations

Seondary Level of Prevention

preventive measures that lead to early diagnosis and prompt treatment of a disease, illness, or injury to limit disability, impairment or dependency and prevent more severe pathogenesis

*ex: pap smears

Tertiary Level of Prevention

preventive measures aimed at rehabilitation following significant pathogenesis

*ex: cardiac rehab

Qualifications

to sit for the

CHES

a bachelor’s, master’s, or doctoral degree from an accredited institution of higher education AND… an official transcript that clearly shows a major in health education

OR

an official transcript that reflects at least 25 semester hours or 37 quarter hours of course work with specific preparation addressing the Areas of Responsibility of Health Education Specialists

9 Assumptions of Helath Promotion

1.       Health status can be changed

2.       Health and disease are determined by dynamic interactions among biological, psychological, behavioral, and social factors

3.       Disease occurrence theories and principals can be understood

4.       Appropriate prevention strategies can be developed to deal with the identified health problems

5.       Behavior can be changed and those changes can influence health

6.       Individual behavior, family interactions, community and workplace relationships and resources, public policy all contribute to health and influence behavior change

7.       Initiating and maintaining a behavior change is difficult

8.       Individual responsibility should not be viewed as victim blaming, yet the importance of health behavior to health status must be understood

9.       For health behavior change to be permanent, an individual must be motivated and ready to change

Health Education

the process of educating people about health

any planned combination of learning experiences designed to predispose, enable adn reinforce voluntary behavior conducive to health

any combination of planned learning experiences based on sound theories that provide individuals, groups and communites the opportunity to acquire information and the skills needed to make quality health decisions

Health Promotion

any planned combination of educational, political, regulatory and organizational support actions and conditions of living conducive to the health of individuals, groups, and communities

any planned combination of educational, political, environmental, regulatory or organizational mechanisms that support action and conditions of living conducive to the health of individuals, groups, and communites.

Health promo/logic model attempts to convey...

...visually the connection between the program activities and the programs desired outcome

3 F's of Health Promo Program Planning

Flexability

Fluidity

Functionality

education and ecological assessment phase 

 of precede/proceed

Educational & Ecological Assessment: Phase 3 –

 identifies and classifies the many factors that have the potential to influence a given behavior into three categories: predisposing, reinforcing, and enabling.

 social assessment of precede/proceed

Social Assessment (situational assessment): Phase 1 –

seeks to subjectively define the quality of life (problems and priorities) of those in the priority population – identify, describe, prioritize

MATCH

Multilevel Approach To Community Health = an ecological planning perspective that recognizes that intervention approaches can and should be aimed at a variety of objectives and individuals.

1.       Individual

2.       Interpersonal

3.       Organizational

4.       Societal

5.       Governmental

central focus of SMART

                Social Marketing Assessment and Response Tool

Heart of model = phase 2 – 4; acquiring a broad understanding of the consumers who will be recipients of a program and its interventions; Seeks to understand consumer before interventions are developed or implemented

Epidemological Data

Traditional vital indicators (ex: mortality, morbidity, and disability data) as well as genetic, behavioral and environmental factors.   ---- gain additional significance when it can be shown that the described health problems are the result of modifiable health behaviors and that spending money to promote healthy lifestyles and prevent health problems makes good economic sense.

first step planners should take to gain support of decision makers

planners need to have a sound rationale for creating a program that is supported by evidence that the proposed program will benefit those for whom it is planned.

why is it important to conduct a literature review?

Planning Commitee

also known as steering committee or advisory board – the collective group of individuals who have the responsibility of creating a program and then overseeing its implementation and evaluation

What type of data collection is timely and expensive?

                Primary data collection

NGO

Non-Governmental Organization

*ex: United Way

nominal group process

highly structured process in which a few knowledgeable representatives (5-7) are asked to qualify and quantify specific needs

needs assessment

                the process of identifying, analyzing and prioritizing the needs of a priority population

mission statement

 the short narrative that describes the

general focus or purpose of a program

Goal

                general statement of intent

terms used in outcomes used for objectives and goals:

attempt, build, change, clarify, connect, define, design, develop, evaluate, estimate, find, gather, group, hypothesize, identify, invent, join, justify, keep, locate, measure, name, observe, organize, pair, plan, propose, qualify, recognize, record, reduce, seek, select, show, solve, supply, test, translate, try, unite, visit, volunteer, write

What is a process objective?

daily tasks, activities, and work plans that lead to the accomplishment of all other levels of objectives; clerical work

ecological perspective that recognizes multiple levels of intervention - what are the multiple levels?

Behavior change theory – ecological perspective: multilevel interactive approach to examining the influences on health-related behaviors and conditions. Emphasizes the interaction between and the interdependence of factors within and across all levels of a health problem

1.       Intrapersonal or individual

2.       Interpersonal

3.       Institutional or organizational

4.       Community

5.       Public policy

Theory of Reasoned Action

developed to explain not just health behavior but all volitional behaviors, “that is, behaviors that can be performed at will.” Relationship between attitude, belief, intention, and behavior

Transtheortical Model

2^nd most popular – an integrative framework for understanding how individuals and populations progress toward adopting and maintaining health behavior change for optimal health; uses stages of change to integrate processes and principles of change from across major theories of intervention. Core constructs include the stage of change, the process of change, the pros and cons of changing, and self-efficacy. Based on critical assumptions about the nature of behavior change and interventions that can best facilitate change.

                Stages of change:

1.       Precontemplation – not intending to change

2.       Contemplation – intending to change within 6 months

3.       Preparation – actively planning to change

4.       Action – overtly making changes

5.       Maintenance – taking steps to sustain change and resist temptation to relapse

average reading level for general public:

 6th grade

Environmental Change Strategies

designed to change the structure or types of services or systems of care, to improve the delivery of health promotion services; changes in those things around individuals that may influence their awareness, knowledge, attitudes, skills, or behaviors; do not necessarily require action on part of the priority population.

The "culture" of an organization

supporting participates - in community organizing area

seldom involved but help swell the ranks, and may contribute in non-active ways or through financial contributions

most accessible assets in community mapping

primary building blocks: located in neighborhoods and are largely under the control of those who live the neighborhood; can be organized into the assets of individuals (individual business; personal income) and those of organizations or associations (chamber of commerce; religious organizations)

peer education

a process wherein individuals are educated by others who have similar characteristics or standing as themselves

canned program

one that has been developed by an outside group and includes the basic components and materials necessary to implement a program

in-kind support

    non-financial support of a program such as free materials or volunteer time

 RFP

Request for Proposal: a call made by funding agencies to alert individuals and organizations that it will receive and review grant proposals

soft money

  a source of funding that is not an ongoing part of the operating budget

start up dollars

                aka: seed dollars: funds designated to start up a new program or project

Diffusion of Innovation Theory - know %

                explains a pattern for how innovations are adopted in a population –

1.       Innovators – 3%

2.       Early adopters – 14%

3.       Early majority – 34%

4.       Late majority – 34%

5.       Laggards – 16%

4 Ps of Marketing

1.       Product – what you are offering that will meet the customer’s needs

2.       Price – what it costs the priority population to obtain the product & its associated benefits

3.       Place – where the priority population has access to the product or where they can engage

4.       Promotion – communication strategy for letting the priority populations know about your product and how to obtain or purchase it

IRB - why is this important?

Institutional Review Board – serve to safeguard the rights, privacy, health, and well-being of those involved in the evaluation/research.

under MATCH model know what TIA is

Targets of Intervention Actions – those individuals who exert influence or control over the personal or environmental conditions that are related to the target health and behavior goals.

appropriate sources for building a rationale

literature – books, articles, government publication and other documents that explain the past and current knowledge about a particular topic.

define 501 c(3)

non-profit organization; public charity

1.       Increased worker morale

2.       Potentially greater employer loyalty

3.       Improved employee resiliency and decision making quality

4.       Positive public and community relations

5.       Increased worker productivity

6.       Informed, health care cost-conscious workforce

7.       Recruitment tool

8.       Retention tool

9.       Opportunity for cost savings via: reduced sick leave absenteeism

10.   Opportunity for cost savings via: reduced short and long term disability claims

11.   Opportunity for cost savings via: decreased health care utilization

12.   Opportunity for cost savings via: reduced premature retirement

13.   Opportunity for cost savings via: decreased overall health benefit costs

14.   Opportunity for cost savings via: fewer on the job accidents

15.   Opportunity for cost savings via: lower casualty insurance cost

16.   Opportunity for cost savings via: smaller total workforce

17.   Opportunity for cost savings via: reduced medical leave time

18.   Opportunity for cost savings via: reduced occupational medical costs

planning committee, steering committee, advising committee - all synonymous – interchangeable

the collective group of individuals who have the responsibility of creating a program and then overseeing its implementation and evaluation

priority population

                the people for whom the program is intended

telephone interviews

 use random digit dialing

 categorical funding

                funds that are earmarked or dedicated to support programs aimed at a specific health problem

mission statements, goals, and objections - what area of responsibilities for health educators are they closely linked to

Responsibility II: plan health education strategies, interventions, and programs

       **formulate appropriate and measurable program objective

Responsibility IV: conduct evaluation and research related to health education

**carry out evaluation and research plans

What does a criterion element of an objective look like?

SMART

Specific, Measureable, Achievable, Realistic, Time-Phased

scope - refers to curriculum

                the breadth and depth of the material covered in a curriculum

What intervention strategy usually has the highest penetration rate?

Communication strategies

difference between intangible and tangible

tangible: specific item, money, number of items sold

intangible: behavior, time, effort, discomfort, number of people who change behavior

characteristics/adjectives that could describe an innovator

                venturesome, independent, risky and daring; want to be the first to do things

segmentation

process of identifying groups of consumers that share similar characteristics and will respond in a like way to marketing strategy

stakeholder

any person or organization with a vested interest in a health program usually decision makers, program partners or clients

 Key marketing principal that apply to social marketing in health

 understand priority population

able segment priority population

having a good understanding of the diffusion theory

instead of exchanging money for a tangible item and the related benefits, we are often exchanging a product and it’s benefits (that may not be received for a long time) for costs that are greater than money

intervention is a theory based strategy

experience to which those in the priority population will be exposed or in which they will take place

primary data collection looks like

                data collected by interacting with priority population

done first hand

1.       single-step or cross sectional surveys

2.       multi-step survey: Delphi Technique

3.       Community Forum

4.       Meetings

5.       Focus Group

6.       Nominal Group Process

7.       Observation

8.       Self-Assessment

know PRECEDE/PROCEED model fairly well - know steps

                Best known model; most often used; comprehensive innature; found in many gov. prgms

              PRECEDE:            

Predisposing, Reinforcing & Enabling Constructs in Educational/Ecological Diagnosis & Evaluation

PROCEED:

Policy, Regulatory, & Organizational Constructs in Educational & Environmental Development

8 Phases:

1.       Social Assessment

2.       Epidemiological Assessment

3.       Educational & Ecological Assessment

4.       Administrative & Policy Assessment  & Intervention Alignment

5.       Implementation

6.       Process Evaluation

7.       Impact Evaluation

8.       Outcome Evaluation

basic assumptions of health status

it can be changed – health behavior change is very complex, and health educator should not to change every person with whom they come into contact

entry level health educator characters to do competent work

National Health Educator Competencies Update Project (CUP)

Framework

7 Areas of Responsibility

Framework

comprised on the seven major areas of responsibility, which define the scope of practice, and several different competencies and sub-competencies which further delineated the responsibilities.

 The 7 Areas of Responsibility

1.       Assess individual and community needs for health education

2.       Plan health education strategies, interventions and programs

3.       Implement health education strategies, interventions, and programs

4.       Conduct evaluation and research related to health education

5.       Administer health education strategies, interventions and programs

6.       Serve as a health educator resource person

7.       Communicate and advocate for health and health education

*** under these 7areas of responsibility are 35 competencies and 163 sub-competencies***

 any combination of measurements obtained during the implementation of program activities to control, assure or improve the quality of performance or delivery.  – short questionnaire or focus group

 the immediate observable effects of a program, leading to the intended outcomes of a program; measures of awareness, knowledge, attitudes, skills and behaviors yield impact evaluation data – what’s going to happen right away -

 an ultimate goal or product of program or treatment, measured by mortality or morbidity data in population, vital measures, ect…; long-term in nature and takes more time and resources to conduct

 any combination of measurements obtained and judgments made before or during the implementation of materials, methods, activities or programs to control, assure or improve the quality of performance or delivery – pretesting or pilot testing a program

 any combination of measurements and judgment that permit conclusions to be drawn about impact, outcome, or benefits of a program or method.

-          Ask questions

-          Small group discussions

-          Seek involvement and input

-          Listen without bias

-          Learn beliefs and feelings

-          Learn about language, humor, gestures, values, norms, & expectations

-          Use culturally relatable examples

the bottom-up, grassroots mobilization of citizens for the purpose of undertaking activities to improve the condition of something in the community

define INTERpersonal channels of communication and know example

example: support groups, small classes – reaches larger number of people and is less expensive than intrapersonal

what do community advocacy activities look like?

1.       Voting behaviors

2.       Electioneering

3.       Direct lobbying

4.       Integrate grassroots lobbying into direct lobbying activities

5.       Use the internet

6.       Media advocacy

a.       Newspaper letters to the editor and op-ed articles

b.      Acting as a resource person

MATCH Framework

- a general summary

 - central core

- it's main focus

general summary:

an ecological planning perspective that recongnizes that intervention approaches can and should be aimed at a variety of objectives and individuals

central core:

emphasizing program implementation

main focus: