Health education monographs最新文献

The view that individual behavior change is the primary goal of health education presents several serious problems. Although individual behavior does contribute to health and disease, social organization is perhaps a more powerful influence. The use of behavior change as the primary tool for health education raises grave ethical issues. Health education which seeks to change individual behavior has also failed to have a significant impact on public health. An alternative strategy is health education for social change. The goal of this approach is to involve people in collective action to create health promoting environments and life-styles. Several contemporary models for and principles characteristic of health education for social change are described.

Increasingly, health workers are concerned with the alteration of complex and deeply embedded behaviors; essential to these tasks is an understanding of the other's situation as he or she views it. This study took the perspective of the patient, inductively generating a conceptual formulation to explain and understand life after a heart attack. The basic problem of minimizing losses under conditions of uncertainty and unknown parameters of action is confronted. Resolution is achieved through "cutting back," which has three major stages: (1) immobilization, characterized by explaining and estimating the damage; (2) resumption, in which patients figure the complex calculus of the new situation to determine what they must cut back, what they should cut back, and what they will and will not cut back; and (3) new normal, when the major work is that of adjusting to the permanent changes wrought by the heart attack experience which affect identity. Exploratory diagnosis of complex health education problems through a "grounded theory" approach is demonstrated by the study.

Successful health education programs should be based on well-integrated community systems and networks. A health educator encountering community disintegration assumes a responsibility for taking a community organization effort. A case study of such an effort, based on Rothman's locality development model, is described. Community diagnosis and program development stages are detailed. Community health projects were among the outcomes attributed to this project.

This paper offers a critique of present research methods used in the literature drawn upon by health education practitioners, students, and teachers. Weaknesses of deductive methods and of theory which is highly general are noted in terms of their implications for the advancement of health education theory and practice, and in terms of their consistency with traditional principles of practice. The grounded theory method--an inductive approach usually used with participant observation and interview data--is described, and the major arguments for its value are presented. In particular, the empirical generation of middle-range theory can provide a strong link between more general theory and situations faced by practitioners, and definitions of problems are not prematurely closed to reinterpretation from other perspectives. Several recommendations are given for changing the research orientation of health education.

The health educator's role as a community organizer raises a number of ethical dilemmas for the practitioner. Such basic prescriptions given the health educator as "start where the people are" and "change by choice, not by coercion" must be carefully examined in light of the realities which sometimes make strict adherence to these theoretical goals difficult in practice and problematic from an ethical perspective. The importance of avoiding unintentional "victim-blaming" in the selection of targets for community organization and the necessity of acquainting communities with possible negative or unanticipated outcomes of organizing efforts are underscored as critical ethical issues for the health educator engaged in community organization activities.

Studies were conducted with children ages 7 to 12 years to develop an instrument to measure children's health locus of control. Findings provide evidence that the Children's Health Locus of Control scale has acceptable levels of reliability, internal consistency, and construct validity. Item analysis and factor analysis were performed to determine item effectiveness and existence of significant subscales. Implications of this research for health education of children are disscussed. Links between the theoretical basis for the locus of control construct and a more comprehensive explanation of health behavior are outlined.

Given the startling number of job-related illnesses and injuries which occur every year, occupational health and safety, a hitherto neglected topic, deserves significant attention in the school health education curriculum. Youngsters need to be exposed to this field before they become indifferent or callous toward diseases and accidents in the workplace and while the opportunity still exists to weight health and safety considerations in selecting a career. In addition, when students take up regular employment, they cannot rely on industry, government, or organized labor to protect them fully from occupational illnesses and accidents; they must possess the skills and attitudes necessary to safeguard themselves. Occupational health and safety education in the schools can focus on general awareness, skill development, and job-specific information. The field can be easily and appropriately integrated with a number of current health education topics. Examples of integration are provided for eleven typical areas of a school health education curriculum.