Certified Health Education Specialists Research Articles

Harnessing Health Education: An Overview of Strategies and Impact During the COVID-19 Era

ABSTRACT Background The COVID-19 pandemic, a multifaceted crisis, affected all dimensions of human health, necessitating a multifaceted intervention to direct and modify public behavior. Purpose This study aimed to explore the role of health education in achieving this goal during the pandemic. Methods We conducted a Rapid Narrative Review using a quantitative lens to evaluate the impact of health education research and modeling in the context of the COVID-19 crisis. Five databases – PubMed, Web of Science, Science Direct, SCOPI, and MEDLINE – were searched for articles published from 2019 to 2022. Results Throughout the pandemic, Certified Health Education Specialists (CHES) have been pivotal, dynamically adjusting their roles to the evolving situation. Their contributions can be divided into three main phases: the initial outbreak, the vaccine development period, and the post-pandemic recovery stage. The Health Belief Model (HBM) emerged as the predominant theory employed to encourage preventive behaviors. Discussion In the face of global threats such as the COVID-19 pandemic, health education is a critical ally to other medical and clinical disciplines, providing vital leadership and guidance. Translation to Health Education Practice This study provides valuable insights for health educators, helping them select more effective models and strategies for their intervention programs.

Impact of Nutritional Education Intervention on Food Choice Motivations and Eating Behaviors Among Latin American University Students

ABSTRACT Background Nutritional interventions can help to develop healthy eating patterns during the transition to university, which is a critical transition for all college students. Purpose This research aims to analyze eating behaviors and food choices through sustainable nutritional education interventions with college students from a multinational university in Latin-America. Methods The nutritional intervention had eight sessions emphasizing lifestyle nutrition patterns. There was an intervention group (n = 85), and a control group (n = 80). This research evaluated the eating behaviors and food choice motivators before and after the intervention. Results The nutrition education interventions showed that the group under intervention improved, changing from unhealthy to moderately healthy habits, whereas the control groups remained in unhealthy eating behaviors. Food choice motivations slightly differ from the two groups after the intervention. Discussion The control group students reflected on their lack of awareness of good eating habits so that current trends could influence their food choices in social networks associated with the pandemic, economic factors, and supply. Translation to Health Education Practice The findings from this research highlight opportunities for Certified Health Education Specialists focused on project development and evaluation.

A Case-Control Study of Cognitive Factors Affecting Colorectal Cancer Screening Participation in 50–70-Year-Old Iranian Adults

ABSTRACT Background Colorectal cancer (CRC) is the most common cancer diagnosed worldwide. CRC can be effectively prevented or treated if detected early, through screening. Purpose This study aimed to determine the influencing factors of CRC screening participation in 50–70-year adults in Iran. Method A total of 354 adults who never participated in the CRC screening from two health centers in Isfahan in September 2022 were selected randomly. A group of 329 sex and age-matched adults with a history of CRC screening was selected as a control group. Logistic regression analyses were applied to assess the cognitive differences between the two groups. Results According to the results, Knowledge (OR = 1.61, 95% CI:1.36–1.9), perceived susceptibility (OR = 1.17, 95% CI:1.04–1.3), response efficacy (OR = 1.24, 95% CI:1.09–1.41), and self-efficacy (OR = 1.13, 95% CI:1.06–1.2) among the control group and perceived barriers (OR = 0.88, 95% CI:0.85–0.92) in the case group, were significant factors influencing participation in the CRC screening. Discussion Results of this study suggest that an HBM education model is an advantageous approach to increase CRC screening participation in adults. Translation to Health Education Practice Certified Health Education Specialists are key personnel in using the HBM model of care and facilitators of behavioral change that will be resulted in improved participation in CRC screening.

COVID-19 Health Education Activities: An Analysis of a National Sample of Certified Health Education Specialists (CHES®/MCHES®) in Response to the Global Pandemic.

The National Commission of Health Education Credentialing, Inc. (NCHEC) created the Category 1 COVID-19 Claim Form Opportunity to document how Certified Health Education Specialists (CHES®) and Master Certified Health Education Specialists (MCHES®) assisted communities during the COVID-19 pandemic. Using data submitted by CHES®/MCHES® (n = 3,098 claim forms), the purpose of this study was to (a) describe the settings where CHES® and MCHES® completed their pandemic work and (b) assess differences in the type of pandemic work completed by CHES® compared with MCHES® based on specific Areas of Responsibility (AOR) for Health Education Specialists. Findings showed that CHES® and MCHES® engaged in seven AOR during the pandemic, with the largest proportion of CHES® (n = 859; 33%) and MCHES® (n = 105; 21.9%, documenting COVID-19-related activities in health departments. CHES® reported higher engagement than MCHES® in activities such as COVID-19 reporting/tracking, χ2 (1, N = 3,098) = 27.3, p < .001; outbreak response, χ2 (1, N = 3,098) = 4.3, p = .039; and vaccination, χ2 (1, N = 3,098) = 5.2, p = .023. Conversely, MCHES® reported higher participation than CHES® in screening/testing, χ2 (1, N = 3,098) = 174.2, p < .001; administration of budgets/operations, χ2 (1, N = 3,098) = 30.1, p < .001; and adapting educational activities at college/universities, χ2 (1, N = 3,098) = 46.1, p < .001. CHES® were more likely than MCHES® to indicate working in all AOR except for Area 2-Plan Health Education/Promotion. Results support that employer-verified health education skills in all AOR were transferable during COVID-19, especially for CHES® employed within state/county health departments.

Financial, Occupational and Physical Challenges and Blood Glucose Monitoring in Type 2 Diabetes.

Blood glucose monitoring effects are changing for people living with type 2 diabetes. However, there is a lack of recent data surrounding financial, occupational, or physical stressors that affect the adherence of diabetes self-management practices. This article looks to examine specific financial, physical, and occupational challenges in adherence to blood glucose monitoring in type 2 diabetes. Data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 Pre-Pandemic data of adults 18+ were analyzed. These data were used to examine the relationships between insurance coverage, health status, occupation, and self-monitoring of blood glucose levels in the United States. This study found that respondents had a statistically significant association with five variables: prescription drug coverage (in-part or full), occupation status, gender, age, and three race subcategories (non-Hispanic White, Black, and Other-Multiracial) with blood glucose monitoring. This study may help certified health education specialists (CHES) and diabetes care and educator specialists (DCES) to better identify which groups of individuals are at highest risk for poor adherence to specific blood glucose monitoring in type 2 diabetes.

The Implementation of Farm-to-University Program in Historically Black Colleges and Universities: Assessment of Feasibility and Barriers

ABSTRACT Background Farm-to-University (Farm2U) programs make healthy eating accessible, easier, and the default option. Yet, few published studies have focused on Farm2U implementations in Historically Black Colleges and Universities (HBCUs) in conjunction with measurements of implementation barriers using the consolidated framework for implementation research (CFIR). Purpose The purpose of this study was to assess the feasibility of delivering a Farm2U program in four HBCUs in North Carolina. Methods Using a quasi-experimental pre-posttest design, four HBCUs were allocated to either the intervention or the control group. The program was administered over a 4-month period and data were collected at baseline and at post-program implementation. Results With a target sample size of 128, we successfully recruited 351 participants, retaining 138 at follow-up, for a retention rate of 39%. Twelve CFIR constructs were measured, ten emerged as facilitators and two as mixed barriers/facilitators to program implementation. We observed an increase in local produce purchases and a significant increase in the daily intake of fruits for students. Discussion This study demonstrated that a Farm2U program is feasible in HBCUs. Translation to Health Education Practice: Certified Health Education Specialists can use the findings to implement Farm2U programs that promote healthy food environments in school settings.

Physical Literacy Research in the United States: A Systematic Review of Academic Literature

ABSTRACT Background Researchers within transdisciplinary fields examine physical literacy; however, substantial changes have been suggested regarding the evaluation and reporting of physical literacy within health education. Purpose This systematic review provides an overview of a) physical literacy literature published in the U.S.; b) scholars, disciplines, and contexts represented in available U.S-based physical literacy studies; and c) explicates the progression of physical literacy in the U.S. over the last 20 years. Methods Utilizing the PRISMA-P 2015, 36 manuscripts met the inclusion criteria. Results Concepts such as health, education, activity, school, development, life, competence, and knowledge were strongly related to physical literacy. Most reviewed studies operationalized the physical literacy construct, applied physical literacy elements to various health and educational contexts, provided overviews and assessments of curricula and program interventions, or delineated between definitions and understandings of physical literacy. Discussion Constructive debate continues over the meaning, purpose, and outcomes of physical literacy, allowing future research endeavors to bridge existing philosophical and pragmatic perspectives by testing new evidence-based interventions. Translation to Health Education Practice This study exposes gaps in knowledge to inform Certified Health Education Specialists (CHES) on how to successfully conceptualize physical literacy in various educational contexts. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

Health Educators in State/Local Public Health Departments: Training Needs and Awareness of Emerging Areas of Public Health Practice.

Although great progress has been made to define the field of health education and provide a voluntary certification system for professionals, research about the governmental health educator and health education specialist workforce is limited. The 2017 PH WINS (Public Health Workforce Interests and Needs Survey) provides valuable data on understanding the workforce demographics, attitudes, and training needs of governmental public health workers, including health educators, and informs future investments in workforce development efforts nationally. The purpose of this article is to examine demographics, job engagement and satisfaction, training needs, certification, and other characteristics of health educators and certified health education specialists (CHES) from PH WINS. We analyzed the data to describe the health educator workforce and compared it with the national governmental workforce across a range of variables. Compared with the national 2017 PH WINS sample, health educators were relatively younger, more ethnically diverse, more likely to be educated with an advanced degree, and were predominately employed in local versus state public health agencies. Health educators sampled were significantly more knowledgeable of all public health concepts compared with the national 2017 PH WINS respondent workforce. Comparison of CHES versus non-CHES professionals is also provided, along with practice and policy implications based on the data. This is the first detailed analyses of health educators in state and local health departments, with important findings and implications related to workforce composition, satisfaction, retention, and training. Further cross-sectional workforce research is needed to understand the current strengths and gaps in the health education workforce.

Technical Writing for the Health and Fitness Professional

Megan Poole, Ph.D.,is an assistant professor of English at the University of Louisville. Her research and teaching are situated at the intersections of rhetoric, feminist science studies, and technical writing. Her work has appeared or is forthcoming in Visual Communication Quarterly, Western Journal of Communication, Journal for the History of Rhetoric, and Quarterly Journal of Speech, among other venues. Kristi McClary King, Ph.D., CHES,is an associate professor in the Exercise Physiology and Community Health programs in the Department of Health and Sport Sciences at the University of Louisville in Kentucky. She is a Commonwealth Institute of Kentucky Scholar, an associate editor for ACSM’s Health & Fitness Journal®, a national ACSM Health and Science Policy Representative, and a Certified Health Education Specialist. Dr. King is the principal investigator on multiyear research studies that focus on the improvement of health, specifically through physical activity and nutrition interventions and policies. Dr. King earned her Ph.D. in Health Education from Southern Illinois University Carbondale and completed postdoctorate training in Physical Activity and Public Health Research with the University of South Carolina’s Arnold School of Public Health and Centers for Disease Control and Prevention. Disclosure:The authors declare no conflict of interest and do not have any financial disclosures.

Historical and Contemporary Aspects of Health Literacy in Certified Health Education Practice

ABSTRACT Health Education Specialists’ (HES) role in health literacy is paramount. Health literacy has been immersed within health education practice for decades, as evidenced by past health education practice analyses. Health literacy is developed and enhanced through a variety of educational, environmental, and policy interventions designed to foster greater personal and community influence over a range of determinants of health. HES are instrumental in fostering health literacy and engaging and empowering individuals to improve individual and community health outcomes. The most recent health education practice analysis, HESPA II-2020, validated eight Areas of Responsibility, all of which relate to health literacy. This article highlights how health literacy is embedded in the work of HES as they assess population needs, plan and implement programs, develop and deliver communication and educational interventions, conduct evaluation and research, administer programs, and engage in advocacy work. Health literacy is also threaded within the profession’s Code of Ethics. Earning CHES® or MCHES® certification demonstrates HES possess professional competency and commitment to the health education profession. Engaging in health literacy professional development advances the capacity of HES in all Areas of Responsibility associated with the Certified Health Education Specialist profession. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

Feasibility of Play-Based Dance to Promote Physical Activity in Second Grade Students

ABSTRACT Background Physical activity (PA) is associated with positive health outcomes. However, children’s access to physical activities they enjoy may be limited. Purpose To evaluate second-grader’s PA against the U.S. DHHS goals to see if a before-school, play-based dance program contributed to these goals. Operational feasibility was evaluated using activity trackers to measure minutes and intensity of PA. Methods A SWOT analysis contributed to intervention implementation. Twenty-seven second-graders enrolled in the Intervention or Comparison group and wore activity trackers three days/week for eight weeks. A multivariate analysis of variance was used to determine differences between the PA intensity of the two groups each week. Results All children achieved the U.S. DHHS activity goals. The Intervention group (n =11) averaged 18 more minutes of daily moderate-to-vigorous intensity PA than the Comparison group (n = 10). More girls than boys chose to attend the morning dance, which was implemented for 31 of 50 school days. Discussion Our findings support dance as a feasible PA that contributed to activity goals when designed with health and fitness in mind. Translation to Health Education Practice Certified Health Education Specialists can use a SWOT analysis and activity trackers to assess opportunities to add PA with guided dance.

Health Education Specialists’ Attitudes toward End-of-Life Education And Planning

This study explored attitudinal differences of Certified Health Education Specialists (CHES) and Master Certified Health Education Specialists (MCHES) toward providing end-of-life education. From a national CHES/MCHES list, we stratified health education specialists by geographic location then randomly selected participants. In our sample (N = 373), older individuals, those who cared for terminally ill persons/families, and those who had death and dying education had more positive attitudes toward providing end-of-life education. We offer three approaches to address the advance care-planning crisis: 1) providing additional end-of-life education to medical professionals, 2) assisting medical schools with incorporating experiential learning, and 3) community outreach.

Aerobic Walking Exercise and Lifestyle Habits Interact with Sleep Quality, Stress, and Life Satisfaction: Results from a Randomized Crossover Study

ABSTRACT Background: Physical exercise interacts with sleep quality, stress and life satisfaction. Purpose: The current study examined the effectiveness of regular aerobic walking on sleep quality, stress and life satisfaction and to explore the associations between lifestyle habits and sleep quality, stress and life satisfaction. Methods: A 12-week randomized cross-over study with fifty-four participants was conducted. Results: Sleep quality (p = .002, r = −.46), stress (p = .007, r = −.38), and life satisfaction (p = .003, r = −.42) showed favorable changes in the intervention group and only life satisfaction increased in the control group (p = .003, r = −.43). Alcohol consumption showed positive correlation with sleep quality (p < .05). Males and females did not differ regarding sleep quality, stress and life satisfaction (p > .05). Discussion: The improvement of sleep quality, stress and life satisfaction was significant in the intervention group, although changes in control group did not indicate big differences. Translation to Health Education Practice: This study provides information and guidelines for Certified Health Education Specialist to design, implement and evaluate sleep education programs. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

How Do Patient-Centered Communication, Emotional Well-Being, Confidence in Health Information-Seeking, and Future Time Perspective Influence Health Self-Efficacy?

ABSTRACT Background: Health self-efficacy acts as a vital mediator in the causal pathway from awareness of self-management to self-care behaviors. However, little is known about the underlying predictors of this concept. Purpose: Guided by existing theories and models, this study tested the effects of patient-centered communication, emotional well-being, confidence in health information-seeking, and future time perspective on individuals’ perceived efficacy in managing health. Methods: Data from Cycle 3 of HINTS 5 (n= 3239) were examined through hierarchical ordinary least squares (OLS) regression analysis. Results: All these four variables were found to have significant positive associations with health self-efficacy. In particular, emotional well-being and confidence in seeking health information had the highest size effect. Discussion: The findings enrich the existing literature by identifying the four potential determinants of self-efficacy in managing health. Translation to Health Education Practice: Several implications for health education and promotion can be drawn. First, there is a need for Health Educators to implement interventions aimed at promoting patient activation and offering easy access to high-quality health knowledge. Second, Certified Health Education Specialists should design more tailored and culturally appropriate health promotion programs to help individuals exercise human agency, establish long-term goals, and keep a positive mind-set.

The Role of Health Education Specialists in Conducting Rapid HIV Testing

There are over one million people living with HIV in the United States; an estimated 16% are unaware of their status. More innovative testing strategies are needed, as evidence suggests that persons most at risk for HIV, or who may present with early infections, are not being reached. Expanding the role of health education specialists can make HIV testing routine and more accessible, and help achieve the national goals of decreasing HIV infection and increasing knowledge of HIV status. This paper focuses on the role of Certified Health Education Specialists (CHES)/Master CHES as being professionally prepared to conduct HIV testing.

Faculty Perceptions of Certifications in Health Education and Public Health: Implications for Professional Preparation

Leaders in the fields of public health and health education/health promotion have been advocating for required credentialing for almost two decades. Recently, some have questioned whether increasing the number of certified professionals could help better differentiate properly trained health educators and public health professionals from others seeking to fill jobs in this professional area. The purpose of this article is to determine how the CHES/MCHES (Certified Health Education Specialist/Master Certified Health Education Specialist) and CPH (Certified in Public Health) credentials are regarded and promoted within the field of health education/health promotion. A cross-sectional survey research design was employed to determine program directors’ ( N = 90) views of credentialing issues. The health belief model and the transtheoretical model were used to determine perceived barriers, benefits, and self-efficacy with regard to promoting credentialing and readiness to require the CHES or CPH exam as part of the undergraduate curriculum. Ninety undergraduate programs completed the survey with the majority reporting that they do not require credentialing of faculty and students as part of their program of study. More than 70% of respondents, however, indicated that they thought credentialing in the fields of public health and health education/health promotion is an important issue. Most program directors indicated there is value in having students credentialed in health education or public health, yet few programs required the CHES or CPH exam as part of their curriculum or exit assessment. There are opportunities to use credentialing both in assessing program curriculum alignment with competencies and student mastery of said competencies.

P93 A Multi-State Evaluation of the Knowledge of the Background and Dangers of Popular Fad Diets Among Cooperative Extension Agents in Family and Consumer Sciences

<h3>Background</h3> Cooperative Extension Services (CES) provides research-based information to communities. Rapidly changing trends leave communities seeking reliable information. There is a need to assess CES agents' knowledge about fad diets to develop effective professional trainings. <h3>Objective</h3> To assess general and potential adverse effects knowledge of fad diets of CES agents and factors influencing that knowledge. <h3>Study Design, Setting, Participants</h3> An online survey assessed CES agents employed in Louisiana, Texas, Mississippi, and Arkansas working in family and consumer science, nutrition, or related fields. The survey included demographic items, certifications held, years of experience, professional association memberships, education level and knowledge items to assess general and adverse effects knowledge of low-carbohydrate diets, intermittent fasting, detoxes, and cleanses. IRB approval was obtained from Louisiana Tech University. State office designates distributed the survey link to eligible agents. <h3>Measurable Outcome/Analysis</h3> Descriptive statistics characterized respondents. Knowledge items addressing diet premises and adverse effects were scored and categorized by diet type. ANOVA testing determined factors that influenced knowledge. <h3>Results</h3> Eligibility was met by 138 respondents. The most reported length of employment was 1-10 years (42%), and master's degrees for education level (63%). The mean score for total knowledge of fad diets was 70%. Respondents scored higher for general knowledge (75%) than adverse effects questions (65%). Members of the Society for Nutrition Education and Behavior (SNEB) and the Academy of Nutrition and Dietetics (AND) scored highest for total knowledge (72%), as didRDN, DTR, and Certified Health Education Specialist (CHES) certifications (74%). An ANOVA yielded a significant effect for CHES certification, F (1, 2) = 5.16, <i>P</i> = .03 and for RDN/DTR certifications, F (1, 0) = 4.83, <i>P</i> = .03 for adverse effects knowledge. Respondents (80%) chose webinars as the preferred delivery method of professional education. <h3>Conclusions</h3> Findings can be used to create needed meaningful professional development for Family and Consumer Sciences agents.

Fitness Wearables and Exercise Dependence in College Women: Considerations for University Health Education Specialists

ABSTRACT Background Research has elucidated some harmful aspects of fitness wearable devices including their role in exacerbating disordered eating and exercise behaviors in young adults. Purpose: The purpose of this study was to examine 1) if use of wearables was associated with exercise dependence and 2) prevalence of compensatory behaviors (CB) in response to not meeting goals set within the wearable. Methods: University students completed an anonymous online survey with the Exercise Dependence Scale-21. Participants also provided information about wearable use and CB (e.g. restricting food) in response to not meeting fitness goals. Multiple linear regression assessed the association between wearable use, CB, and exercise dependence. Results: Majority of participants using wearables reported CB if they did not meet goals set by wearables. Using wearables and engagement in CB were associated with higher exercise dependence scores. Discussion: This study suggests that wearables may exacerbate harmful compulsions, like exercise dependence, and should be recommended with caution by health education specialists. Translation to Health Education Practice: Consequences of wearable use are important to consider in the development of health education materials and interventions promoting wearable use. Certified Health Education Specialists should consider how to address negative aspects of fitness technology in physical activity promotion.

Health Educator Perspectives on Seeking Medicaid Reimbursement in Indiana.

Health education is a growing field. However, there is confusion about the role delineation of health education specialists (HES) and other health education (HE) providers. Additionally, recent reimbursement opportunities allow employers to bill for HE services but offer confusing language regarding eligible service-providing professionals. This study surveyed health educators in Indiana to assess knowledge, attitudes, and perceived abilities to bill Medicaid and other insurers for HE services. Using a cross-sectional research design, an original 22-item Web-based questionnaire was developed and distributed to all Certified Health Education Specialist/Master Certified Health Education Specialist (CHES/MCHES) practitioners residing in Indiana. Additional respondents were recruited using a snowball technique, as original respondents asked to share the survey with colleagues. A final data set of 61 respondents was analyzed. All respondents' organizations provided HE services, with the majority indicating they do not charge and do not bill for HE services. Additionally, 60% of the respondents agreed that HES should be reimbursed for services, and the vast majority believed reimbursement to be important for the field. With recent reimbursement opportunities for HE and preventative health services, it is important that HES advocate for the profession and for potential reimbursement opportunities, such as Medicaid, to enhance the field and support HES jobs.

Feeding the Student Body: Unequal Food Insecurity Among College Students

ABSTRACTBackground: A growing but limited body of research has assessed food insecurity among college students. The majority of these studies relied on convenience or nonprobability samples. Purpose: The purpose of this study was to assess the prevalence and odds of food insecurity among undergraduate students. Methods: Online survey data were collected in the spring of 2017 from a random sample of college students attending a 4-year university. A final sample of 378 undergraduate students was included in this study. Pearson's chi-square and logistic regression analyses were used to examine differences in the prevalence and odds of food insecurity across student groups. Results: Nearly a third (32%) of undergraduate students were food insecure. Racial and sexual minorities had a higher prevalence of food insecurity and higher odds of food insecurity. Students who had a background of family financial struggles and who lack housing security had a higher prevalence and higher odds of food insecurity. Discussion: The results are discussed with attention to the role of higher education in reproducing or reducing unequal opportunity in the United States. Translation to Health Education Practice: Certified Health Education Specialists should consider interventions with the differentiated risk of food insecurity in mind.