chapter 1

Copyright © 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Planning, Implementing, & Evaluating

Health Promotion Programs: A Primer – James F. McKenzie, Brad L. Neiger, Rosemary Thackeray

Fifth Edition

Lecture by J. McKenzie

Health Education, Health Promotion, Health Educators, and Program Planning

Chapter 1


Health Status in the U. S. - 1

• Looking back; the 20th Century– Many infectious diseases were controlled; chronic diseases

became a greater concern– Average life span increased 29.7 yrs.– Health promotion era of public health began in 1974

– Lalonde Report in Canada– Health Information & Health Promotion Act in U.S.

– Three modifiable health-damaging behaviors–tobacco use, lack of physical activity, & poor eating habits responsible for much of the ill health

– Healthy People; behavioral risk factors became more important– Healthy People initiatives began in 1990


Health Status in the U. S. - 2

• Looking ahead; the 21st Century– Healthy People initiatives have continued–2000, 2010, 2020

– Health behavior is more important; behavioral patterns are the single most prominent domain of influence over health prospects in U.S. (McGinnis et al., 2002)

– Need for health information to be understood by the average person

– Need for health professionals to provide public with the information & skills to make quality health decisions


Comparison of Most Common Causes of Death & Actual Causes


Health Education defined…

• Health education – “any combination of planned learning experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire information and the skills needed to make quality health decisions” (Joint Committee, 2001, p. 99)

• Health education – “any planned combination of learning experiences designed to predispose, enable, and reinforce voluntary behavior conducive to health in individuals, groups, and communities” (Green & Kreuter, 2005, p. G-4).


Health Promotion defined…

• Health promotion – “any planned combination of educational, political, environmental, regulatory, or organizational mechanisms that support actions and conditions of living conducive to the health of individuals, groups, and communities” (Joint Committee, 2001, p. 101).

• Health promotion – “any planned combination of educational, political, regulatory, or organizational supports for actions and conditions of living conducive to the health of individuals, groups, and communities” (Green & Kreuter, 2005, p. G-4).

• Health promotion takes into account that human behavior is not only governed by personal factors, but also the structure of the environment” (Vogele, 2005, p. 272).


The Relationship Between Health Education and Health Promotion


Health Educators - 1

• Health educator – “A professionally prepared individual who serves in a variety of roles and is specifically trained to use appropriate educational strategies and methods to facilitate the development of policies, procedures, interventions, and systems conducive to the health of individuals, groups, and communities” (Joint Committee, 2001, p. 100).

• The work of health educators in the United States as it is known today has evolved over time and only really defined in the last part of the 20th century

• Need for health educators to provide education at all three levels of prevention


Levels of Prevention


Health Educators - 2

• 1979, Role Delineation Project began to define the role of the entry-level health educator

• 1985, seven “Areas of Responsibility” generic to all entry-level health educators regardless of the setting

• 1997, three additional “Areas of Responsibilities” for advanced-level health educators

• 1998-2004, Competencies Update Project (CUP); reverify the entry-level & verify the advanced-level

• CUP Model– Responsibilities, competencies, & sub-competencies for entry-level,

advanced-level 1, & advanced-level 2– Third versions of the Framework

• Framework used by NCHEC (for CHES), NCATE, & SABPAC


Areas of Responsibility*

• I – Assess Individual and Community Needs for Health Education

• II – Plan Health Education Strategies, Interventions, and Programs

• III – Implement Health Education Strategies, Interventions, and Programs

• IV – Conduct Evaluation and Research Related to Health Education

• V – Administer Health Education Strategies, Interventions, and Programs

• VI – Serve as a Health Education Resource Person

• VII – Communicate and Advocate for Health and Health Education

*NCHEC, SOPHE, & AAHE, 2006


Eligibility Guidelines to Sit for the CHES Examination


Assumptions of Health Promotion

• Health status can be changed

• Health & disease are dynamic

• Disease theories & principles

can be understood

• Appropriate prevention

strategies can be developed

• Behavior can be changed &

those changes can impact

health

• Many things contribute to health & influence behavior change

• Initiating & maintaining a behavior change is difficult

• Individual responsibility should not be viewed as victim blaming

• For behavior change to be permanent, the person must be motivated & ready to change


Program Planning

• Many of the responsibilities of health educators are some way involved with planning, implementing, & evaluating

• Logic model helps to see what goes into the development of a program

• A logic model “is a simplified picture of a program, initiative, or intervention” (U. of WI, 2002, p. 2)

• Logic models can take many different shapes, but most include: 1) inputs (or resources), outputs (or activities), and outcomes (or results or effects)


Logic Model for a Colon Cancer Prevention Program

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