EDUcation AND COMMunication CE
EDUcation AND COMMunication CE
EDUcation AND COMMunication CE
In the ecological model health status and behavior are the outcomes of interest (McLeroy, Bibeau,
Steckler & Glanz, 1988, p. 355) and viewed as being determined by the following:
Public policy— Local, state, national, and global laws and policies.
Includes polices that allocate resources to establish and maintain a coalition that serves a
mediating structure connecting individuals and the larger social environment to create a
healthy campus. Other policies include those that restrict behavior such as tobacco use in
public spaces and alcohol sales and consumption and those that provide behavioral
incentives, both positive and negative, such as increased taxes on cigarettes and alcohol.
Additional policies relate to violence, social injustice, green policies, foreign affairs, the
economy, global warming.
Interpersonal processes and primary groups— Formal and informal social networks and
social support systems, including family, work group, and friendship networks.
SCHOOLS: Health behaviour change programs in schools include classroom teaching, teacher
training and changes in school environments that support healthy behaviour.
WORKSITES: Both source of stress and social support. Effective worksite programs can harness
social support as a buffer to stress, with the goal of improving worker health and health practices.
Used to reduce chronic disease risk factors.
HEALTHCARE SETTINGS: For high risk individuals, patients, their families, and surrounding
community, and in-service training of healthcare providers. Greater emphasis on implementing
health behaviour change and provider focused quality improvement strategies. Use of community
health workers for patients discharged from hospitals is considered as a strategy to reduce
readmission rates.
HOMES: By traditional means such as home visits or through communication channels such as
internet, telephone calls and mails. Strategies like mailed tailored messages and motivational
interviewing by telephone make it possible to reach larger groups and high-risk groups in a
convenient way that reduces barriers to their receiving motivational messages. In-home coaching
that helps people improve their home health environments to support health behaviour change has
also shown promise.
CONSUMER MARKETPLACE: The advent of home-health and self-care products has created
new opportunities for health education but also means of misleading consumers about the potential
health effects of items they can purchase. Social marketing is being used by health educators to
enhance the salience of health messages and improve their persuasive impact. E.g. adding calorie
information to menus and graphic warning labels on cigarette packs.
Communication cannot be effective unless it is seen or heard by its intended audience. A common
cause of failure at this stage is ‘preaching to the converted’. An example of this would be if posters
asking people to attend for antenatal care are placed at the clinic itself only, or talks on the subject
are only given at antenatal clinics. These methods only reach the people who are already motivated
to use the service. However the groups you are trying to reach may not attend clinics, nor have
radios or newspapers. They may be busy at the times the health education programmes are
broadcast on the radio. Communication should be directed where people are going to see or hear the
messages. This requires careful study of your intended audience to find out where they might see
posters or what their listening and reading habits are.
Any communication must attract attention, so that people will make the effort to listen or read the
information. Examples of failure at this stage are:
Once the person pays attention to a message they will try to understand it. For example, two people
may hear the same radio programme or see the same poster and interpret the message quite
differently from each other — and differently from the meaning intended by the sender. A person’s
interpretation of a communication will depend on many things.
A communication should not only be received and understood — it should be believed and
accepted.
It is usually easier to promote a change when its effects can be easily demonstrated. For example,
ventilated improved pit latrines do not smell and will be more accepted by the community because
of this feature.
A communication may result in a change in beliefs and attitudes, but still not influence behaviour or
action. This can happen when the communication has not been aimed at the factor that has most
influence on the person’s behaviour. For example a person may have a favourable attitude and want
to carry out the action, such as using family planning — but some people around may prevent the
person from doing it. Sometimes the person might not have the means (enabling factors) such as
money, skill or availability of services to take action. As a result there will be no behaviour change.
Stage 6: Improvement in health
Improvement in health will only take place if the changed behaviours have been carefully selected
so that they really influence health. If your messages are based on outdated or incorrect ideas,
people could follow your advice — but their health would not improve.