Participatory Health Education Research Articles

Development and evaluation of a culturally adapted digital-platform integrated multifaceted intervention to promote the utilization of maternal healthcare services: a single-arm pilot study

BackgroundThe utilization of hospital delivery and antenatal care (ANC) is essential for improving maternal and newborn outcomes. However, social and cultural barriers in underdeveloped rural areas hindered maternal care utilization. This study aims to design and evaluate the effectiveness of a culturally adapted digital-platform intervention to promote maternal care utilization among women in ethnic minority communities in China.MethodsFrom January 1st, 2020, to December 31st, 2021, all pregnant women in Mianshan town, Liangshan Autonomous Prefecture, were invited to participate in the intervention. The multifaceted intervention included participatory and cultural-tailored health education on a popular social media platform, transportation subsidies, and capacity building and economic incentives for healthcare providers. The effectiveness of the intervention was evaluated by comparing two groups: mothers who gave live birth before the intervention (January 1st to December 31st, 2019) and mothers whose entire pregnancy period was covered by the intervention. The primary outcomes were the rate of hospital delivery and ANC utilization. Data on pregnant women were retrospectively collected through telephone surveys and the maternal and newborn’s health monitoring system.ResultsA total of 237 intervention sample and 138 pre-intervention sample were included. The intervention group demonstrated significantly higher rates of hospital delivery (97.5% vs. 87.7%, p < 0.001), timely initiation of ANC (73.0% vs. 62.3%, p = 0.031), and timely completion of five-time ANC visits (37.1% vs.4.3%, p < 0.001) compared to the pre-intervention group. The intervention group was more likely to utilize hospital delivery (OR = 9.26, 95%CI [2.83–30.24], p < 0.001) and ANC, including timely initiation of ANC (OR = 2.18, 95%CI [1.31–3.62], p = 0.003), completion of five ANC visits (OR = 1.72, 95%CI [1.05–2.83], p = 0.032), and timely completion of five ANC visits (OR = 15.12, 95%CI [6.24–36.64], p < 0.001).ConclusionsThe culturally adapted digital-platform integrated multifaceted intervention effectively promoted the utilization of hospital delivery, timely initiation of ANC, and completion of ANC visits in the Yi ethnic community in China. This study provides valuable insights for future interventions targeting maternal healthcare services in underdeveloped ethnic minority communities worldwide.Trial registrationChinese Clinical Trial Registry, ChiCTR2300073219. Registered 4 July 2023 - Retrospectively registered, https://www.chictr.org.cn/showproj.html?proj=199202.

Practice of Intelligent Platform for Mental Health Education in Colleges Based on Automatic Identification and Retrieval Algorithm of Philosophical Texts

Image retrieval based on semantic correlation analysis of philosophical texts and extended retrieval of similar images based on SIFT features. According to the analysis of natural language processing technology, the keywords and their semantic associations in the user's text requirements are obtained. The dynamic transmission and transformation of text value under the influence of multi-system factors outside the text is the premise and basic feature of system reconstruction. The author tries to use psychological sitcoms to explore a participatory, experiential, and situational mental health education method, and guide students to discover, analyze and solve psychological problems by themselves, so as to know themselves, understand others, gain self-growth, and promote health. For the development of body and mind, use genetic algorithm to design paragraph retrieval algorithm, use the search algorithm of philosophical text to query the feature extraction of mental health of college students, and then use the index algorithm to carry out text modeling and philosophical development.

Recognizing territorial vulnerabilities to Zika virus: a participatory health education model

INTRODUCTION: Considering that the engagement of the population in the control of arboviruses should not be restricted to care to avoid domestic foci of the Aedes aegypti, health education initiatives must approach the social health determinants in the territories. OBJETIVE: To describe a proposal for a pedagogical model aimed at community participation in recognizing vulnerabilities to the Zika virus and the main results of its application. METHODS: Based on Paulo Freire’s critical-problematizing pedagogy and within the framework of vulnerability and human rights, a workshop model was developed and applied in participatory research to train community health workers to diagnose local vulnerabilities to the Zika virus in a community of Rio de Janeiro, Brazil. Four 20-hour workshops were held in weekly meetings with 38 participants. It included activities involving territory mapping, experiences with the virus, and identifying community spaces vulnerable to the proliferation of mosquitos. RESULTS: The proposed pedagogical model identified territorial spaces vulnerable to the proliferation of mosquitoes that do not depend only on the will or behavior of its residents. These aspects are conditioned to social contexts that express the tense relationship between residents, the State, and drug traffickers with a vital power relationship in the territory. CONCLUSIONS: By transcending the traditional vertical health education model, the proposed participatory method was sensitive and timely to capture the participants’ deep knowledge of the territory of residence, not only to identify mosquito foci but, above all, understanding multiple vulnerability determinations.

Participatory health education on school (re)inclusion of the adolescent cancer survivor.

to analyze school (re)inclusion of an adolescent cancer survivor before/after participatory health education with adolescents. qualitative and participatory research that included data from the medical record of an adolescent rhabdomyosarcoma survivor and Talking Map dynamics (to diagnose the demand for learning and assess changes). The body-knowledge dynamics were applied in the educational intervention. In a public school in Rio de Janeiro, the adolescent (reference case) and nine people (four teachers and five teenagers) generated empirical materials, which became the content analysis objects. strangeness to changes in an adolescent cancer survivor's body image, bullying, and acceptance were problematized in educational body-knowledge dynamics through relationships between changes and barriers to welcoming. The participatory educational process was essential in raising awareness by promoting re-inclusive actions. participatory-problematizing education contributed to constructing a new collective identity and improvement in school interaction among peers.

A Survey of Urinary Schistosomiasis among Secondary School Students in Jalingo Town, Jalingo Local Government Area, Taraba State

This study was carried out to determine the prevalence of urinary Schistosomiasis among secondary school students in Jalingo town, Jalingo local government area, Nigeria. Ordinary centrifugal sedimentation technique was used and the deposits were examined microscopically. Data collected were analyzed using chi square. Out of the 200 samples examined, 37 (18.5%) had infection, with no significant difference (p&gt;0.05) in infection rates between males (21.1%) and females (15.1%). Among the two schools sampled School A had the highest prevalence (22.0%) followed by School B (15.0%) with no significant difference (p&gt;0.05). Children aged 9-12 years (60.0%) were more infected than those aged 19-21 (13.0%) (p&lt;0.05).There was a close relationship between haematuria and positive urine samples as 72.7% of the students tested positive excreted blood in their urine (p&lt;0.05). Major risk factors were poor hygiene, ignorance and poverty. The results of this study show that secondary school students harbor infection and are a source of transmission of Schistosomiasis in the study area. Planning and provision of drugs for treatment should be considered in disease prevention and control programmes. Community participatory health education should be encouraged as the first step in reducing infection and transmission of the disease.

Construction and practice of "3-PR" participatory health education model

Based on participatory idea, we constructed a novelty model of participatory health education, which was based on participatory research as the module, participatory role-playing as the core module, participatory review as enhanced module (abbreviation to as 3-PR). We applied it to pre-selected health officer health promotion activities, and randomized controlled trials were designed. The results showed that 3-PR model of participatory health education might be more effective in promoting health literacy than conventional health education methods. 3-PR health education model has the advantages of participation, practicality, fun and flexibility, integration and education, which has certain reference significance for exploring health education methods and improving the health of the whole people. Key words: Participatory research, participatory role-playing, participatory review (3-PR); Participatory health education; Construction; Practice; Health literacy

Rates and risk factors for human cutaneous anthrax in the country of Georgia: National surveillance data, 2008–2015

IntroductionAnthrax is endemic in the country of Georgia. The most common cutaneous anthrax form accounts for 95% of anthrax cases and often is self-resolving. Humans are infected from processing contaminated animal products, contacting sick animals, or by insect bites.ObjectiveWe aimed to describe the burden of human cutaneous anthrax and associated risk factors using the national surveillance data.MethodsWe extracted all human cutaneous anthrax cases from Electronic Integrated Disease Surveillance System (EIDSS) from 1 January 2008 to 31 December 2015. We conducted descriptive analyses to characterize the number of confirmed, probable and suspected cases by age groups, gender, ethnicity, year and geographic area.ResultsOut of 911 reported cutaneous anthrax cases, 299 (33%) were rejected. Out of remaining 612 cases, 437 (71%), 172 (28%), and 3 (<0.004%) were classified as confirmed, probable and suspected cases of cutaneous Anthrax, respectively; 467 (76.3%) were male. Georgians accounted for 56% (343/612) of cutaneous anthrax cases. Handling animal products (aOR 4.36, 95% CI 2.61–7.26) and living near pastoralist routes (aOR 2.74, 95%CI 1.57–4.76) were associated with cutaneous anthrax.ConclusionsThis study provides eight-year trends for cutaneous anthrax in humans in the country of Georgia. A comprehensive explanation for the observed rise and fall of the incidence rates of human cutaneous anthrax in 2008–2015 remains to be clarified but is likely associated with discontinuation of mandatory national livestock vaccination in 2008 coupled with weakened human and animal national health systems which were disrupted after the Soviet Union collapsed. Our analysis identifies living near pastoralist routes, handling animal products and travel to endemic areas within two weeks before the disease onset as risk factors for cutaneous anthrax. The evidence underscores the importance of One Health recommendations to activate anthrax awareness campaigns, supervise the destruction of known anthrax carcasses, record global position system coordinates of sites and disinfect infected soils and introduce a participatory health education tool on anthrax.

Health literacy as a challenge for health education

Scientific literature demonstrates a well-established correlation between education and health literacy; education and health outcomes; health literacy and health outcomes. Health literacy has a mediating role between education and health. Health literacy is known as a complex concept, it has multiple definitions, underlying meanings and conceptual models. Diversity of health literacy can be a challenging motivator for health education. In-depth study of scientific literature was carried out to highlight the link between health literacy and health education and to emphasize health literacy challenges for health education. Five health literacy challenges for health education were identified: 1) health literacy as an outcome related to health education interventions; 2) multi-layered health literacy or different levels of health literacy; 3) the concept of health literacy and its comprehensiveness; 4) shift from a passive to more interactive and empowering health education; 5) cultural context of health literacy and health education. Enhanced health literacy definitions and conceptual models require more complex, comprehensive, socially oriented, culture sensitive, participatory health education.

Urinary schistosomiasis in communities around Kiri Lake, Shelleng Local Government Area, Adamawa State, Nigeria

The objectives of the study were to determine the prevalence of urinary schistosomiasis in the different communities, the intensity of infection, prevalence among gender and age groups and to relate infection with parent’s occupation. A study on the prevalence of urinary schistosomiasis was conducted in four villages around Kiri Lake in Shelleng Local Government Area, Adamawa State, Nigeria. Two hundred and thirty two urine samples were collected from four primary school children randomly selected from within the four study communities. Overall, prevalence of urinary schistosomiasis was 48% (111/232), with males recording 49% (69/142) and females 47% (42/90). The total mean egg count (MEC) was 8.3. There was no significant difference in prevalence between males and females (P˃0.05). Prevalence was higher among age groups, with the 13-15 year old age group having the highest 62.96% (17/27) and the 4-6 year old age group had the least 37% (19/52). There was no statiscally significant difference in prevalence among the different age groups (P>0.05). Infection was also high among children of fishermen 59.09% (13/22), followed by farmers’ children 56.25% (45/80) and the least prevalence was among children of teachers 20% (3/15). Old Banjiram had the highest infection of 91% (21/23), while Kwadadai had the least 36.8% (21/57) (P<0.05). Old Banjiram and children in the 10-12 years age group had the highest mean egg count of 10.6 and 9.4 respectively. The study reveals a high prevalence of urinary schistosomiasis. And therefore portable water source should be made functional in all communities surrounding the lake. While rehabilitation and repair of the existing water borehole system in the community should be effected as well as drilling new additional boreholes to serve their water needs. Commun JASEMity participatory health education on this neglected tropical disease in the area is needed on knowledge of the disease, the intermediate host and transmission pattern. Since school children harbour infection and are a source of infection of schistosomiasis in endemic communities, planning and provision for their treatment should be considered in control programmes. Keywords: Schistosoma haematobium , Prevalence, Kiri lake, Socio-economic, School children, Nigeria

The Hannover Patient University: Advanced Mini-Med School concept and evaluation results

Objective:To determine whether Hannover Medical School’s Patient University, which was developed as the first university-based health education institution in Germany, offers a valuable means of conveying health-related knowledge, competencies and the ability to reflect on health information to its participants.Design:Participatory health education formats included interactive lectures, learning stations and practical training with tutors.Setting:The Patient University was conducted at the facilities of Hannover Medical School, a major German maximum-care hospital and research institution.Methods:To evaluate the programme, data were prospectively collected from participants from 2007 to 2009 using standardised and anonymous questionnaires. One questionnaire included information on sociodemographic data, such as health status, age, gender and post code. A second questionnaire evaluated levels of participant satisfaction, new knowledge and skills gained and understanding of the information provided.Results:Approximately 1,935 participants enrolled in at least one of 60 events from 2007 to 2009. The response rate from the questionnaire collecting sociodemographic data was 61.4%. A total of 35.2% of participants responded to the event evaluation. After matching both questionnaires, 1,188 person-specific data sets were available for analysis. Most respondents were women (74.7%), and the median age was 62 years (range: 16–88 years). Satisfaction with the events was rated very positive (average 1.7 on a scale of 1 = excellent to 6 = poor). Nearly two-thirds of the participants acquired new health-related knowledge and were highly satisfied with the quality of the information received. Participants who self-rated their health status as ‘poor’ tended to be more critical of what they had received than those in good health.Conclusion:We consider the approach a viable health education advance, and future Mini-Med School programmes may benefit from its methodological and evaluative insights. The development of target group-specific information should be the focus of prospective initiatives and related research.

Community's perceptions of pre-eclampsia and eclampsia in Sindh Pakistan: a qualitative study.

BackgroundMaternal mortality is of global public health concern and >99 % of maternal deaths occur in less developed countries. The common causes of direct maternal death are hemorrhage, sepsis and pre-eclampsia/eclampsia. In Pakistan, pre-eclampsia/eclampsia deaths represents one-third of maternal deaths reported at the tertiary care hospital settings. This study explored community perceptions, and traditional management practices about pre-eclampsia/eclampsia.MethodsA qualitative study was conducted in Sindh Province of Pakistan from February to July 2012. Twenty-six focus groups were conducted, 19 with women of reproductive age/mothers-in-law (N = 173); and 7 with husbands/fathers-in-law (N = 65). The data were transcribed verbatim in Sindhi and Urdu, then analyzed for emerging themes and sub-themes using NVivo version 10 software.ResultsPre-eclampsia in pregnancy was not recognized as a disease and there was no name in the local languages to describe this. Women however, knew about high blood pressure and were aware they can develop it during pregnancy. It was widely believed that stress and weakness caused high blood pressure in pregnancy and it caused symptoms of headache. The perception of high blood pressure was not based on measurement but on symptoms. Self-medication was often used for headaches associated with high blood pressure. They were also awareness that severely high blood pressure could result in death.ConclusionsCommunity-based participatory health education strategies are recommended to dispel myths and misperceptions regarding pre-eclampsia and eclampsia. The educational initiatives should include information on the presentation, progression of illness, danger signs associated with pregnancy, and appropriate treatment.

Cutaneous Anthrax surveillance by Person, Place, and Time in Georgia (2008-2013)

National surveillance of cutaneous anthrax cases in Georgia (EIDSS 2008-2013) appears secondary to epizoonotic events that are more likely to occur in populations that work with unvaccinated sheep and cattle. Six-year mean incidence rates per 100,000 were 1.32 for Georgian nationals and 9.31 for Azerbaijani nationals. The contrast between groups was pronounced in Kvemo Kartli and Kakheti where a large proportion of Azeris pastoralists live and migrate along animal corridors. One Heath recommendations include promotion of anthrax awareness campaigns, the destruction of carcasses, mapping and disinfect infected soils, and introduce a participatory health education anthrax tool.

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Objectives This study aimed to explore community perceptions, and traditional management practices surrounding pre-eclampsia and eclampsia in Pakistan. Background They hypertensive disorders of pregnancy are the second leading cause of maternal mortality globally, of which >99% occur in less developed countries. Methods A qualitative study was conducted in Matiari and Hyderabad Sindh, Pakistan from February to July 2012. Altogether 26 focus group discussions were held with women of reproductive age and female decision makers ( N = 173) and male decision makers ( N = 65). The data was transcribed verbatim in Sindhi and Urdu, the data were then analyzed for emerging themes and sub-themes using QSR NVivo-version10. Results High blood pressure in pregnancy was mainly recognized as severe headache, and there was no local name to describe either this condition or the seizures of eclampsia. The majority of participants were aware that a woman can develop hypertension in pregnancy; however, progression of illness from pre-eclampsia to eclampsia was poorly understood. It was widely believed that mental stress and worries in pregnancy cause pre-eclampsia. Hypertension in pregnancy was considered to be dangerous as it could result in death of mother and baby; whereas, very few believed further complications could occur after birth. Seizures during pregnancy were thought to be caused by weakness, anemia, and stress. Many perceived seizures to be a health emergency for both mother and fetus. Self-medication for pre-eclampsia symptoms was common; in addition, some used alternative treatments for pre-eclampsia and eclampsia. Conclusions Community-based participatory health education strategies are recommended to address myths and misperceptions about the hypertensive disorders of pregnancy. These educational initiatives should include information on the presentation, progression, and treatment of pre-eclampsia and eclampsia. Disclosures A.R. Khowaja: None. R.N. Qureshi: None. S. Sheikh: None. S. Zaidi: None. R. Salam: None. D. Sawchuck: None. M. Vidler: None. P. von Dadelszen: None. Z. Bhutta: None.

Reducing environmental tobacco smoke exposure of preschool children: a randomized controlled trial of class-based health education and smoking cessation counseling for caregivers.

Objectives: To assess counseling to caregivers and classroom health education interventions to reduce environmental tobacco smoke exposure of children aged 5–6 years in China. Methods: In a randomized controlled trial in two preschools in Changsha, China, 65 children aged 5–6 years old and their smoker caregivers (65) were randomly assigned to intervention (n = 33) and control (no intervention) groups (n = 32). In the intervention group, caregivers received self-help materials and smoking cessation counseling from a trained counselor, while their children were given classroom-based participatory health education. Children’s urinary cotinine level and the point prevalence of caregiver quitting were measured at baseline and after 6 months. Results: At the 6-month follow-up, children’s urinary cotinine was significantly lower (Z = –3.136; p = 0.002) and caregivers’ 7-day quit rate was significantly higher (34.4% versus 0%) (p < 0.001; adjusted OR = 1.13; 95% CI: 1.02–1.26) in the intervention than control group. Conclusions: Helping caregivers quitting smoke combined with classroom-based health education was effective in reducing children’s environmental tobacco smoke exposure. Larger-scale trials are warranted.

Pedometers and participatory school-based health education – an exploratory study

Purpose – The purpose of this paper is to explore how pedometers (simple gadgets that count steps) can be used as tools in participatory health education to enhance primary school children's insights into, and abilities to reflect on, physical activity in their daily life. The paper focuses on how using pedometers fosters participation and enhances reflection concerning physical activity. Design/methodology/approach – The paper draws on findings from an exploratory project with sixth-grade classes (12-13 years) in four Danish primary schools. The approach is called Imove. In Imove, pupils use pedometers to study their own patterns of physical activity, transform their data into statistics, and use the statistical representation to reflect on how physical activity is integrated into everyday life patterns, and how different activities constitute an active life. Findings – The paper concludes that pedometers support pupils’ participation in studying their own health practices, and the step data provide new insights into, and encourage pupils to reflect on, the way physical activity is formed into everyday patterns. Research limitations/implications – The study is an exploratory one with four participating school classes. The findings need to be further explored by employing similar methodology in studies with more participants. Nevertheless, there is no doubt that pedometers support pupils’ genuine participation in health educational processes. Practical implications – The findings identify simple measuring technologies, such as pedometers, as potent assets in health education learning processes and call for creative thinking in developing health promotion programmes for young people. Originality/value – Measuring technologies play an increasingly critical role in health research, as well as in individual health regulating practices. This paper contributes with a new perspective by demonstrating the educational possibilities of applying pedometers in participatory school health education.

Participatory school health education on vector-borne diseases: engaging children as change agents

Vector-borne diseases contribute substantially to the global burden of diseases and disproportionately affect poor and under-served populations living in a country like India. Children can be effective change agents of health in their schools, peer groups, families and communities. We evaluated the effectiveness of participatory school health education on vector-borne diseases among 200 high school children, 100 each from government and private schools. Questions regarding vector-borne diseases, mosquito breeding sites, diseases transmitted by them and mosquito control measures were used to assess their knowledge before and after a health education intervention. Education included lecture, role play and community-based group activity. Average overall pretest score was 11.8 ± 5.03 which increased significantly to 19.3 ± 4.69 after intervention. Health education showed significant improvement in knowledge irrespective of type of school, gender or class of study. It was observed that private school children, girls and 10th class students' post-test scores were significantly better than their counter groups. Participatory school-based health education improved the knowledge of children regarding vector-borne diseases. This could be an effective medium in promoting health and possibly behavioural changes in the community. Such school-based vector-borne disease control could be applied to developing countries where there is good school enrolment and attendance.

Innovative Participatory Health Educatio(IPHE): It?s Effect on Mothers? Knowledge, Behavior; and Under Five Year-Old Children Household Accidents Rate

Introduction: Accidents are emerging as a leading cause of childhood morbidity and mortality. The current study was aimed to determine the effect of Innovative Participatory Health Education (IPHE) on mother' knowledge and behavior, and secondly to determine its effect on household accidents rate. Methodology: The study design was a randomized control trial. Mothers who had less than five year-old children were selected randomly for this study. From each administrative unit 30 households were selected as clusters in the intervention and control groups. Sample size was calculated as 300 mothers all were enrolled in the study. Training of 15 participants by IPHE was done for the selected mothers in the intervention group. Then post-test was conducted to assess score of mothers’ knowledge and behavior about home accidents. Results: Mothers household accidents mean score knowledge increased from 8.40 to 16.34 after the intervention in the intervention group. In the control group, it increased from 9.7 to 12.4. The mean score knowledge on immediate intervention increased from 10.40 to 14.42 in the intervention group and increased from 9.7 to 12.4 in the control group. The mean score behavior of mothers about prevention of household accidents increased from 35.4 to 43.0 after the intervention among the intervention group. However, it remained the same as 36.0 in the control group. The mean score behavior of mothers about immediate intervention was increased from 19.32 to 22.96 in the intervention group. The reduction in home accidents rate in the intervention group was from 81.3: 1000 children to 24.9:1000 children. However, the rate was increased from 81.9:1000 children to 95.9:1000 children in the control group. Conclusion: IPHE has significant effect on reduction of household accidents among under five year-old children. Mothers' knowledge and behavior about under-five year old children home accidents improved after intervention with IPHE.

Old age and elderly people: social representations of adolescent students

to know the main elements of social representations about elderly people and old age among adolescents at a public high school. 172 adolescents between 14 and 19 years of age participated. The free evocation of words technique was applied through the terms elderly and old age. The main elements of the representations significantly designed for elderly people were: respect and disrespect, 78; experience, 49; care, 32; wisdom, 23; fragility, 19. For old age: disease, 51; retirement, 27; experience, 27; wisdom, 19; wrinkles, 17. The social representations of adolescents are strongly marked by physical, psychological and social aspects, with positive and negative aspects about old age. Participatory health education activities are needed to make adolescents critically reflect on and the condition of elderly people in contemporary society.

Study on the effect of patients' active participation with health education in diabetes treatment

Objective To explore the application effect of the participatory health education in community diabetes management.Methods 260 diabetic patients were selected and randomly divided into two groups (intervention group and control group).The patients of intervention group were implemented participatory health education.The control group was implemented routine management of chronic disease.Before treatment,the related knowledge,self management ability and attitude questions in two groups were investigated.One year later,the two groups were surveyed with the same question.Results All of the indicators of the intervention group were better than those of the control group.Conclusions Participatory health education can make diabetes medical knowledge popular very well,and improve the self management ability of patients with diabetes,reduce the complications,and improve their quality of life. Key words: Diabetes; Health education; Participatory; Health behavior

Sala de espera para gestantes: uma estratégia de educação em saúde

O objetivo do presente estudo foi descrever as experiências das acadêmicas de enfermagem monitoras do PET-Saúde Enfermagem da Ufal, em 2009/2010, na realização de ações de educação em saúde para gestantes em sala de espera. As ações foram realizadas regularmente na Unidade de Saúde, enquanto as gestantes aguardavam atendimento médico e de enfermagem do pré-natal. Vários temas de interesse para a gestante foram abordados, sempre utilizando métodos criativos e participativos de educação em saúde. Com essas ações, as estudantes aprenderam sobre a dura realidade dessas mulheres e sobre o papel da enfermagem na saúde coletiva, efetivando o cuidar através da educação participativa, em que usuários, familiares e profissionais trabalham juntos para proteger, promover e recuperar a saúde.