Health education monographs最新文献

The concept of voluntariness is central to an understanding of ethical considerations in two aspects of public health education practice: (1) the selection of appropriate interventions, and (2) the selection of appropriate targets for such interventions. The position is taken that most mass communications programs in public health education are persuasive as well as informative in intent. It is argued that the impact of such programs on voluntariness can be analyzed with regard to the rationality and resistibility of the persuasive appeals involved. Considerations of justice, as well as voluntariness and liberty, are reviewed in the discussion of appropriate targets for intervention. The issue of victim-blaming in public health education is explored, and conditions under which behavioral public health programs may be morally justifiable are suggested.

Knowledge-attitude-behavior and values-based models are analyzed with regard to their application to development and evaluation of drug education programs; theoretical problems of these models are identified. The experimental evidence regarding the application of these models to drug education is reviewed. Recommendations are made concerning theoretical, programming, and research implications for drug education and for health education in general.

Risks to individuals engaged in "high risk" behaviors may be present because of the individual's own actions, as in the case of smoking. Alternatively, the risks may be present either because of factors in the environment such as carcinogens, or because of the causal actions of others, such as pollution by industries. Traditionally, justifications for policies that would control hazards and restrict hazardous behaviors have been based on paternalistic principles or on a theory of social justice. Arguments for both are criticized and rejected in favor of a third alternative rooted in utilitarian moral theory. It is argued that: (1) paternalism leads to unacceptable consequences because it would allow too much limitation of individual liberty by policy makers; (2) justice-based arguments are too abstract for public policy problems and often rest on questionable empirical assumptions; and (3) utilitarian suggestions about the use of cost-benefit analysis for the resolution of these health policy problems are more promising than available alternatives, because they provide a solid moral basis for allocating scarce resources and for controlling hazardous behaviors.

Public health programs to prevent disease and promote health are constrained by legal doctrines that protect individuals from intrusive regulation of their health-influencing behaviors. This paper outlines the parameters of acceptable interventions in the context of antismoking legislation and motorcycle helmet safety laws. The authors discuss recent court decisions challenging the constitutionality of these laws and identify criteria the courts apply in reviewing governmental attempts to protect the public from disease or trauma.

Though environmental hazards and lack of medical care continue to threaten the public's health, much recent attention has turned to the role of destructive health-related behavior. If, as Fuchs suggests, changing behavior patterns is the most powerful alternative open to advanced countries in the pursuit of health, the role of the health educator is likely to grow more prominent relative to other health-care professionals. At the same time, that role may change. A campaign to solve the nation's health problems by altering habits of living may require methods which are stronger than the traditional health educator's efforts to facilitate and inform. This paper examines the coercive aspects of some of these possible measures and surveys the moral justifications for a policy of using coercion to bring about the desired changes in health-related behavior. Three such arguments are most plausible: that the coercion is justified by the social benefit; by the benefit to the coerced; and by a right of others in society to prevent the self-destructive individual from placing unfair burdens upon them.

This article describes the important elements of a five-day workshop for teaching health care professionals to design and use simulation/gaming activities. Suggested guielines are identified for planning and conducting a workshop. The importance of early planning is emphasized by identifying the specific objectives of the workshop and preparing the staff to facilitate the attainment of each objective. The selection of staff and participants is discussed. A day-to-day description of a typical workshop is presented. Also included is a description of several content presentations which teach the workshop participants the required skills and knowledge in design, selection, research, and evaluation of simulation/gaming activities.

Gaming-simulation is being developed foruse in a variety of aspects of health care. A mental health diagnostic and therapeutic application is described for problems in parent-teenager relations; it features gaming, videotaping of interactions, and extensive discussion. Two applications which elucidate the nature of discord between couples and two applications for work-group problems are also described. Gaming-simulation is used in basic and continuing education of health professionals for such issues as problems of dying patients and the aged, and prevention of coronary heart disease. Patients rights issues provide a potential focus for opening dialogues between patients and professionals about all facets of health and illness care.

Simulation entails abstraction and representation from a larger system in terms of process as well as structure. Central features are identified and simplified, less important elements are omitted from the model. In medical and health education, simulation enables learners to practice in an environment where mistakes are not costly, such as with simulated patients. Gaming-simulation incorporates role-playing into a defined system of interaction simulating a real world system and is characterized by the degree of structure of the roles and the focus on role interactions. Employment of gaming-simulation is embryonic in health education. Examples included in this Monograph concern problems of aging, hemophiliacs, and the dying; teaching interpersonal skills in psychiatric nursing; interactions of health care systems with their communities; and several other topics. Evaluation is discussed in a separate paper. A variety of health care gaming resources are described.

This study examined the effectiveness of a program for teaching complex medical concepts, the rationale of antacid therapy, to clinic patients with peptic ulcer. Those who already knew the rationale were excluded, and the remaining patients were divided into three groups: I. taught the rationale, II. taught other materials, III. untaught control. Teaching proved effective when: (1) basic concepts were identified and taught, (2) important misconceptions were eliminated, and (3) patient's attention was maintained and their progress monitored with the Socratic method. The key facts were acquired by 85 per cent of the patients within four sessions. However, application of the learned concepts in solving new problems varied with the intelligence of the patient. Certain misconceptions could not be eliminated by the teaching.