The Power of “and” in Health Education Policy and Practice

I am honored as well as humbled to be here with you this morning as the 2011 American Association for Health Education (AAHE) Scholar. There is no greater recognition than the recognition from peers. As we just heard during the AAHE General Meeting, the health education profession is evolving. There is little doubt that the choices being made today by all of us as health educators will affect the future of health education in great ways. These are intentional choices that will allow the profession to meet the needs of health educators in all settings and continue to be a strong advocate for health education research, policy, and practice. I am proud to be a member of this profession and to be engaged in what I think will be a turning point for the profession. Like all of my esteemed AAHE Scholar recipients before me, our passion, our career, and our profession has been a journey. I want to provide a brief glimpse of my journey, of how I got where I am today, and acknowledge a few people who helped me make some good choices along the way. MY HEALTH EDUCATION JOURNEY AND CHOICES I am a health educator. That statement seems self-evident today standing here before you. I am not exactly sure when I came to this realization, but most likely during my doctoral studies at Southern Illinois University at Carbondale (SIUC). The choices I made along the way have helped shape who I am personally and professionally as a health educator. The road to becoming a health educator was not a straight line. Like many freshmen college students today who enter college wanting to become a doctor or lawyer, I wanted to be a dentist. And like many freshmen today, my dream was short-lived when my lack of acumen for physics and calculus became all too apparent. It was time for a choice--one strongly encouraged by the university. I enrolled at a community college and successfully completed an associate of science degree in dental hygiene. I began practicing dental hygiene. But there was a burning desire to earn a bachelor's degree. So, I went back to the University of Toledo, taking most of my courses in the evening while working during the day. I enrolled in several stacked courses, where graduate and undergraduate students were in the same class. This is where I met Dr. James Price, who many of you recognize as the 2008 AAHE Scholar. During my undergraduate program, Dr. Price encouraged me to earn a master's degree and subsequently offered me an assistantship. Knowing little about either, I talked with my parents and the dentists I worked for, Drs. Robert Stearns and William Zouhary. Both not only encouraged me but allowed me to cut my hours back from 40 to 20 hours a week so I could go to school and also have the assistantship. Once in the master's program I found what I enjoyed doing--teaching and conducting research to understand health behavior. My next question was How do I do this full-time? The answer was plain and simple: you need a doctorate degree. Never in my wildest dreams could I have imagined completing a master's degree, let alone a doctorate. So, during our spring break in 1984 my good friend and now colleague Dr. Sharon Desmond hopped in my maroon Chevy Citation and traveled to several universities to check them out. I decided on Southern Illinois University-Carbondale. It was a good choice. But I don't think I still fully understood what being a health educator was or meant. During my time at SIU-C I took courses with such health education legends as Drs. Elena Sliepcevich and Bob Russell (both AAHE Scholars). It was also during this time that I met Dr. Robert McDermott (2000 AAHE Scholar), who was, for a brief time, my major professor and later became a valued colleague at the University of South Florida College of Public Health. During my final year at SIU-C, I had a conversation with Dr. Sliepcevich about accepting an opportunity at a community college as a dental hygiene instructor. Her advice: Stay and finish your degree and become a health educator. …

This paper reviews the status of health education in urban schools in three cities in Liaoning province, China. The cities represent the upper, middle and lower levels of city economy based on the GDP per person within the province. A self-administered questionnaire was provided to 500 primary and secondary schools and 436 questionnaires (87.2%) were returned completed. The questionnaire assessed health education offerings in the schools, permitting the comparison of similarities and differences in school practices, and the identification of obstacles that prevent schools becoming health promoting. The analysis revealed that 0.7% of schools fulfilled criteria for good status of health education. The negative attitudes of school management, teachers and pupils towards health education, as well as the lack of in-service training for staff, were perceived as key obstacles to school health education. Few provincial and school-based policies mentioned pupil involvement in health policy development and only a small number of schools acknowledged the need to improve community and parental involvement. In this paper we discuss the challenges facing provincial education and health authorities, and make recommendations about how to assist Chinese schools to develop and implement high quality health education initiatives.

This paper is a report of a study to explore nurses' perceptions of health promotion and health education practice in a Chinese provincial hospital. Health promotion and health education practices are based on universal constructs. Therefore, such practices should share common principles. To date, most nursing-related studies have been conducted in Europe or in North America. A Husserlian phenomenological approach was adopted. Interviews were conducted in 2006 with a sample of eight nursing students and eight senior nurses. The interviews were audio-recorded and transcribed from Mandarin to English. Data analysis adhered to the framework developed by Giorgi. Reported health education and health promotion-related practices showed results similar to those reported in Europe and North America. Hospital-based nurses were often aware of what health promotion is, but did not have the scope or opportunity to implement it in practice. Instead, they were likely to conduct more limited forms of health education. Actual understanding of health promotion and health education constructs was high with most participants, underpinned by active clinical-based educational support. Some participants were able to conduct broader health promotion activities on a voluntary basis in their own communities. Health education and health promotion are universal health-related constructs. Thus, there is an expectation that all nurses will implement these in a similar fashion. Where possible, hospital-based nurses should strive to improve their health education practices and further embrace wider perspectives of health promotion practice.

Background. Evidence-based policymaking is a type of policy based on valid, timely, and appropriate evidence. This study aimed to explain the evidence-based policy in education and health promotion to students. Methods. The method of the present research was a narrative review. The statistical population included 114 Persian and English articles published between 2010 and 2022 which were indexed in ERIC, ScienceDirect, Sage, SID, Irandoc, Magiran, and Medline databases. The search was done using evidence-based policy, health education evidence, health promotion, health education policy, educational policy and health key words. The search was conducted using the SPIDER framework due to the speciality of the subject being studied. Using Downs and Black checklist for quality assessment, the final research sample included 20 references selected through screening. Thematic analysis was used to codify the texts using the Sternberg method. Results. We extracted 59 concepts and six themes based on coding of the findings. Evidence-based policymaking in educating and promoting student health can be categorized into six themes: the necessity for evidence-based policymaking, the characteristics of evidence-based policymaking, the prerequisites of evidence-based policymaking, the impetus for evidence-based policymaking, the barriers to evidence-based policymaking, and the consequences of evidence-based policymaking. Conclusion. Application of evidence-based policymaking in educating and promoting students’ health, based on global trends, technologies and strategies can lead to efficient education and health promotion policies. This study provided useful, practical guidelines such as filling the theoretical gap, ensuring clarity and motivation, influencing political decisions, and building trust among researchers, the scientific community, and other policy stakeholders to use evidence-based policymaking effectively in students’ health promotion.

This study was carried to assess the roles of health education and promotion in Nigeria. Coronaviruses belong to a large family of viruses causing a wide spectrum of illness, ranging from very mild i.e. Common cold to severe illness such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).In early August 2020, there were nearly 18 million confirmed cases of Coronavirus Disease (COVID-19), including 686,145 deaths globally; very rapid growth in prevalence since the first case was reported to the World Health Organization in December 2019 (WHO, 2020). In a desperate attempt to contain the further spread of the virus, governments across the world have taken public health interventions that are unprecedented. To prevent the further spread of COVID-19 infection, many countries have taken strict measures such as the complete lockdown of a country restricting the movement of people in public, forcing people to stay at home except for emergencies and certain essential jobs. At the same time countries are also trying to scale up their testing capacity and expand their contract tracing system while scientists around the world are in a race to develop a vaccine against the virus as well as drugs to alleviate its symptoms. It is well-known that public health education plays a crucial role in the prevention and control of emerging infectious diseases, but how health providers should advise families and parents to obtain health education information is a challenging question. With COVID-19 (Coronavirus disease 2019) spreading around the world, this rapid review aims to answer that question and thus to promote evidence-based decision making in health education policy and practice Keywords: SARS-CoV, WHO, Nigeria, Corona Virus, Health Education, COVID 19, Pandemic

To determine the extent to which HIV education and health education policies and practices are required by school districts in the United States, a national probability sample of public school districts was surveyed by mail in 1990. Of 2,150 districts selected, 78.1% responded. HIV education was required by 66.9% of districts. Of these, the percentage requiring HIV education increased by grade level from 29.7% in kindergarten to 82.3% in 7th grade, then declined to 37.3% by 12th grade. Districts that required HIV education most often addressed HIV-related prevention skills in the upper grade levels. Similar to requirements for HIV education, health education requirements also declined from 7th to 12th grade, reaching even lower levels than HIV education by the last two years of high school. These declines are of particular concern given that students are most likely to engage in risk behaviors when HIV and health education is least likely to be required. Other practices and policies that support HIV and health education also were lacking in many districts.

In this article we make a case for a shift in health education practice away from teaching young people to be healthy to an understanding of the ways young people learn health. Initially, we illustrate ways in which health educa-tion curricula have developed in Sweden and New Zealand, two countries ostensibly leaning towards a process related health concept in contemporary school curriculum. With a point of departure in socio-cultural learning theory, we then critique the individualistic approach to health education, which characterizes much health policy today, and instead argue for an ap-proach to health education that takes as its starting point the learning that occurs in the lives of young people. Finally, we outline some implications of this approach for health education research and practice. Keywords: health education, learning, individualism, instrumentalism.

This review examines evidence-based practice (EBP) in health education and promotion with a focus on how academically trained health educators develop EBP skills and how health education and promotion practitioners access the literature to inform their activities. Competencies and credentialing in health education related to evidence-based practice are outlined and sources for evidence-based practice literature in health education and promotion are described. An exploratory questionnaire to consider teaching and resources in evidence-based practice was distributed to faculty and librarians from the top 10 ranked health education doctoral programs. Findings highlighted the integral value of EBP instruction to the curriculum. Growth opportunities in evidence-based health education and health promotion for instructors, practitioners, and librarians include promotion and expansion of online evidence-based public health resources to close the evidence-practice gap.

Health educators use several data collection techniques involving qualitative and quantitative methods. One common qualitative data collection technique is the focus group. Although a focus group, when utilized appropriately, can yield useful information, too often in health education practice it is misunderstood and thus misused. This article describes four general misconceptions about the focus group: (1) the focus group is quick, easy, and inexpensive; (2) the focus group can be used as a source of quantitative data; (3) only one or two focus groups are necessary; (4) the focus group opinion accurately reflects or represents individual opinion. A clearer understanding of these concepts will assist health educators to effectively use focus groups to advance health education research and practice. Based on the four misconceptions, suggestions are provided to assist health educators in using focus groups appropriately.

Background and Aim: The actual situation of cultivating the health education ability of students majoring in physical education has not achieved the implementation effect that was in line with policy requirements, and there were no courses related to health care, infectious disease prevention, and treatment specifically designed for the health education system. Therefore, this research aimed to develop management strategies to enhance health education knowledge and practice of student teachers majoring in the physical education program. Materials and Methods: This research was a mixed-methods study, which combined quantitative and qualitative research. The researcher conducted a survey of 296 fourth-year students in 13 universities within Yunnan Province, interviewed 9 primary and secondary physical education teachers, 9 university instructors, and 9 university leaders. The validity of the questionnaire and interview form was validated by five experts. The IOC of the student questionnaire was 0.95 (0.60-1.00). The IOC of the interviewing form for teachers was 0.96 (0.80-1.00), the IOC of the interviewing form for university instructors was 0.96 (0.80-1.00), and the IOC of the interviewing form for university leaders was 0.96 (0.80-1.00). The information obtained from the questionnaires and interviews was used to develop management strategies to improve health education knowledge and practice among physical education students under the scope of management function (POLC). The content of the management strategy was distributed to 19 experts for consensus by the Delphi method for two rounds. The management strategy was adjusted by the researcher and confirmed by the focus group discussion. The questionnaire data were analyzed by mean and standard deviation. Consensus data by the Delphi method were analyzed by median and interquartile range, with the criterion set at a median of ≥ 3.50 and an interquartile range of ≤ 1.50. Results: Fourth-grade students had poor practical abilities in health education, and they had a greater need for improvement in skills and operations. To solve these problems, management strategies were developed with hierarchical concepts, which include four first-level elements, namely, policies, curriculum, extracurricular activities, and competency certification, 13 second-level elements, and 56 third-level elements. Conclusion: The management strategies to enhance health education knowledge and practice of student teachers majoring in the physical education program should focus on four sets of strategies, 13 subsets, and 56 indicators. These management strategies were confirmed and accepted by experts to be appropriate, practical, and feasible strategies to enhance health education knowledge and practice of student teachers majoring in the physical education program.

If health promotion as a field of change for human and ecological health is to maintain its urgency, it needs to continue building its policy credentials. This paper charts the development of policy as a concern for IUHE/IUHPE (International Union for Health Education/International Union for Health Promotion and Education) from the mid-1970s when 'health education policies' were prominent issues, to the launch of Healthy Public Policy (in the 1980s) and Health in All Policy (in the 2000s). We argue that solid conceptual and theoretical foundations exist to frame and develop the relevance and connectedness of health promotion more prominently. We start off with a brief introduction into (health) political science, and then illustrate the urgency of the argument with three case studies. The first takes a critical realist perspective on 'closing the gap' in Australian Indigenous populations. With recent evidence it demonstrates that the core of the policymaking process needs to re-align itself with an Indigenous narrative. The second case study reviews the politics of healthy urban planning and health equity in cities. Taking a critical theory institutionalist view, the case describes how the political and narrative parallels between urban theory and health equity have gone underexplored. With an explicit gaze to connect the two, the field could become a large and influential driver of enhanced health promotion and public health policy. The third case describes the languages, policy frames, and distinctions, in four urban/health paradigms. It shows that unconscious policy and practice bias exists in policy priorities and processes. We conclude with observations and recommendations on the role of health promotion as a conceptual realm and field of activity. We show that all health promoters should be aware of the political nature of their enterprise. Tools and analyses exist to help further action.

Disparities exist in the numbers of American Indians and Alaska Natives (AI/ANs) in the health professions as compared with the general United States (US) population. Numerous factors contribute to this disparity, including inequities in education, healthcare and economic development opportunities. The basis for inequality is rooted in the policy arena. Issues in health professions education blend the arenas of health policy and education policy. Although AI/ANs have a birth right to healthcare and to education programs as a result of treaties signed between the US and tribal governments, these programs are severely under funded. To understand the disparities in health professions education for AI/ANs today, it is important to understand the history of US federal Indian policy over the last two centuries. Following a history of removal, assimilation, reorganization and termination, the current phase of federal Indian policy is tribal self-determination. As a result, opportunities exist to reduce disparities in the number of AI/AN health professionals and in health disparities. AI/AN tribes have the opportunity to work in partnership to coordinate health, education, social and economic development policy to increase the numbers of AI/AN health professionals. Tribes can also make it a priority to coordinate political advocacy efforts to improve funding for AI/AN health and education programs.

This article was migrated. The article was not marked as recommended. IssueThe layers of systems affecting patient care, including that of clinic and hospital policy as well as state and federal laws, are the topic of one of the Accreditation Council for Graduate Medical Education’s six Core Competencies. Health policy, a key aspect of Systems Based Practice, often receives limited exposure in graduate medical education (GME).EvidenceA 15-point framework for teaching health policy in undergraduate medical education was published earlier this decade. At the GME level, several programs – both institutional and specialty-specific - have described their experience teaching health policy to their own learners. We therefore expand on the previously described framework adapting it for the development of a GME curriculum focused on U.S. domestic health policy. In addition, we analyze how well the currently employed Milestones address important health policy concepts.ImplicationsReview of the Milestones of across all specialties reveal that four components - health insurance, history and consequences of major health care legislation, health disparities, and U.S. healthcare system, financing, and payment – remain underrepresented in the current approach to teaching health policy in graduate medical education. We recommend a centralized approach from institutional GME programs to address shared curricular needs in health policy supplemented by tailored content designed to solidify these concepts with a specialty-specific focus.

While health care and educational disparities are known to impact minoritized groups, few research studies have been conducted to examine disparities after childhood acquired brain injury (ABI). The purpose of this study was to explore child and injury factors (i.e., race, socioeconomic status, and length of hospital stay) associated with referral, parent education, and long-term need for children who experienced an early childhood ABI. This study was a secondary analysis of data collected through retrospective cohort chart review and prospective caregiver phone surveys. Exploratory logistic regressions indicated a statistically significant association between child and injury factors and (a) referral to rehabilitation or educational services at hospital discharge (p < .001) and (b) caregiver-reported long-term needs (including both met and unmet needs) for special education services (p = .009). The models for caregiver-reported receipt of education on ABI and caregiver-reported unmet need for special education were not significant. For both significant models, there were no significant individual predictors. Differences in acute and long-term service provision and need after childhood ABI are likely influenced by a complex interaction of individual, injury, and social-environmental factors. Future research should consider how health care and education practice and policy might account for these interactions to support more equitable access to and utilization of services to improve long-term outcomes for all children with ABI. https://doi.org/10.23641/asha.21158878.

I n their introduction to our new journal, Randy Schwartz and Bob Goodman (2000) provide us with three reasons for the choice of the term health promotion rather than health education for the journal's title. They begin by stating that for some, a debate over these two terms is still relevant. As one of the some, I offer some thoughts about why health educators should consider a debate to be relevant using the three explanations provided by these authors. The first reason cited by Schwartz and Goodman (2000), which they call a practical one, is that the abbreviation for a health education practice (HEP) journal would be too close to that of our other journal, Health Education and Behavior (HEB), and thus would be a source of possible confusion. Regrettably, practicality is often inevitable and, in fact, was even used at the Centers for Disease Control and Prevention when the Health Education Network (HEN) decided that its abbreviation was not very complimentary (and possibly sexist as well!). As with the journal title, the Network decided to add the word promotion to the name of the organization, which then became the Public Health Education and Promotion Network or PHEP-NET. The other two explanations by the authors are of greater concern. Their characterization of health education in relation to health promotion may unwittingly undermine the contributions of health education to the field of health promotion. For those who are not familiar with health education as it has been developed in the United States over the past 40 to 50 years, such characterization may further minimize the science and practice of health education as a core discipline of public health. Such minimization may tend to encourage an erroneous interchangeability of the two terms— implied by the question, “What is in a name?”—rather than an appreciation of the complementary roles that each has in improving the public's health. Lest readers be thinking “oh no, another health educator having a professional identity crisis,” let me assure you that this is not the case. With the advent of certification for health educators, the recognition of health educator as a manpower classification by the Department of Labor, and the recent work done for the development of the profession cited by Schwartz and Goodman (2000), my concern about the explanations provided for the choice of journal title is not fueled by a paranoia that the profession of health education will be replaced by that of health promotion. Rather, it is spurred by my feeling that health educators, in their own journal, should be clearly articulating the contribution of the profession to the development of health promotion and thus giving credit where credit is due. These contributions include many decades of leadership and thinking, an ever increasing science base, and the professionalization of health education as a core function of public health. The second reason cited by Schwartz and Goodman (2000) is that, “on a broader level,” the choice of health promotion is “in accordance with the definition offered by Green and Kreuter [1999], recently revised in the third edition of their classic book on health promotion planning.” However, when they contrast the definitions of health promotion and health education found on page 27 of the third edition, the authors do not mention the first edition of the book, Health Education Planning: A Diagnostic Approach (Green, Kreuter, Deeds, & Partridge), published in l980. Indeed, as a health education practitioner trained in that era, I found that the PRECEDE planning model published in this edition was robust enough to include the environmental and ecological dimensions that later appear in the second and third editions of Green et al.’s (1980) book. In commenting in the 1999 edition on the shift from health education to health promotion that occurred around the creation of the Federal Office of Health Information and Health Promotion, Green and Kreuter observe that the operational definition of health