THEORY AND PRINCIPLE OF

HEALTH EDUCATION
Module 4

HEALTH PROMOTION & EDUCATION (DEMA 3253)

DIPLOMA IN ENVIRONMENTAL HEALTH
VICTORIA INTERNATIONAL COLLEGE

PREPARED BY: MR KHAIRUL NIZAM MOHD ISA

DEFINITION OF HEALTH
EDUCATION

▫ Health education is a process which bridges the

gap between health information and health
practices. (President’s Committee of Health
Education, 1977).

▫ Health education is any combination of learning

experiences designed to facilitate voluntary
adaptations of behavior conducive to health
(Green et al. 1980)
THE SCOPE OF HEALTH EDUCATION
• Terms for health education programs
1. Motivation programs
Motivation is referring to the internal dynamics behavior
construction, not to the external stimuli.
Thus, based on the use of motive-arousing appeals.
Not a voluntary change.

2. Behavior modification
Designed to bring about changes in behavior by means of
changes in knowledge or attitudes.
Subjects voluntarily want changes they desire in their own
behavior.
Designed to specifically to increase the degree of self-
control and self-direction.
THE SCOPE OF HEALTH EDUCATION
1. Health counseling and communications
Counseling is more psychotherapeutic rather than educational.
Approach to voluntary change the subject’s health behavior.
By emotional disturbance interferes with voluntary control of
behavior.
THE SCOPE OF HEALTH EDUCATION
• Other forms and methods of health education
1. Community organization
2. In-service training
3. Consultation
4. Group work
5. Computer-assisted instruction
6. Non-computerized teaching machines and audiovisual method
7. Patient teaching
8. Health fairs
9. Exhibits
10. Libraries
11. Conferences
12. Routine health provider-consumer interaction
HEALTH EDUCATION AS INTERVENTION

100
Health education intervention
(a) 80
Percentage of x
population engaged in 60 Reduction in negative health
negative health behavior
behavior (eg. unprotected intercourse)
40

20

Time
 100

(b) 80 Health education intervention

Percentage of
population engaged in 60 Prevented increase in
negative health negative health behavior
behavior (eg. Smoking in teenagers)
40 x
20

Time
 100

(c) 80 Health education intervention

Percentage of
population engaged in 60 Increase in positive health
positive health behavior (eg. Compliance
behavior 40 x with a prescribed regimen)

20

Time
 100

(d) 80 Health education intervention

Percentage of
population engaged in 60
positive health x
behavior Prevented decrease in
40 positive health behavior
(eg. Maintenance of diet)
20

Time
 THE 7 PHASES OF PRECEDE
Phase 6 Phase 4-5 Phase 3 Phase 1-2
Administrative diagnosis Educational diagnosis Behavioral diagnosis Epidemiological & social diagnosis

Predisposing
Direct factors:
communication: knowledge,
public, patients attitudes, values, Nonhealth
perceptions factors
Nonbehavioral Quality of life
causes
Health education Enabling factors:
Availability of Health problems Subjectively
components of Behavioral causes defined problems
health program resources,
accessibility, of individuals or
referrals, skills Behavioral Vital indicators: communities
indicators: Morbidity,
utilization, Mortality, fertility, Social indicators:
Indirect Reinforcing preventive actions, disability illegitimacy,
communication: factors: Attitudes consumption population,
staff and behavior of patterns, welfare,
development, health and other compliance, self- Dimensions: unemployment,
training, personnel, care incidence, absenteeism,
supervision, peers, parents, prevalence, alienation,
consultation, employers, ect. distribution, hostility,
Dimensions:
feedback intensity, discrimination,
Earliness,
duration votes, riots,
frequency, quality,
crime, crowding
range, persistence
THE 7 PHASES OF PRECEDE
• The PRECEDE framework directed the initial attention to outcome
rather than to inputs (begin the health education planning process
from the outcome).

• Phase 1
▫ Begins with a consideration of quality of life by assessing some of
the general problems of concern to the people in the population
of patients, students, workers or consumers.
▫ Social problems can be used as a parameter of the quality of life.

• Phase 2
▫ Identify the specific health problems that appear to be
contributing to the social problems noted in Phase 1.
▫ Use information from epidemiology, medical finding and available
data sources generated by investigators.
THE 7 PHASES OF PRECEDE
• Phase 3
▫ Identifying the specific health related behaviors that appear to be
linked to the health problem chosen as deserving of most attention in
Phase 2.
▫ Nonbehavioral factors: economic, genetic and environmental factors
are indirectly influence health.
THE 7 PHASES OF PRECEDE

• Phase 4
▫ Potential factors that can affect the health behaviors:
1. Predisposing factors (person attitudes, beliefs, values,
perceptions, facilities or hinder person’s motivation to
change)
2. Enabling factors (barriers created mainly by societal force or
systems such as limited facilities, inadequate personal or
community resources, skill and knowledge, lack of income or
health insurance and even restrictive laws and statutes)
3. Reinforcing factors (feedback from subjects which may be
either to encourage or to discourage behavioral change)
THE 7 PHASES OF PRECEDE

• Phase 5
▫ Decide which factors need to be focus for the intervention
program.
▫ The decision is based on the resources and importance
available.

• Phase 6
▫ Implementation of a program

• Phase 7
▫ Evaluate the outcome and diagnose the preceding phases.
THE 7 PHASES OF PRECEDE
• The PRECEDE framework for planning is founded on the
requirements of four disciplines:
▫ Epidemiology
▫ Social/behavioral sciences
▫ Administration
▫ Education

• Successful completion of phase 1,2 and 3 depends heavily on the

use of epidemiological method and information.
• While phase 3 and 4 requires social/behavioral theory and
concepts.
• In the phase of designing and implementing a health education
program require knowledge of educational and administrative theory
and experience.
Thank you for your attention