Teaching Strategies and Health Education

Technical institute of nursing 2 nd year

Prepared by
Community health
nursing staff
2023-2024

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 Pages

1. Terms 2

2. Health education 7

3. Health Education models 16

4. Health educator 20

5. Method of health education 32

6. Teaching materials (aids) 40

7. Health promotion 53

8. Communication 67

9. Health and human behavior 79

10. Health literary 96

11. Electronic health learning 103

12. Blended learning 108

13. Tele-health 113

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 Terms
▪ Health
Is a state of complete physical, mental and social well-
being and not merely the absence of disease or infirmity
▪ Illness
Illness is defines as a state in which a person’s physical,
emotional, intellectual, social, developmental and
spiritual functioning is diminished or impaired
▪ Wellness
It is the condition in which an individual function at
optimal levels.
▪ Health education
Health education is any combination of learning
experiences designed to help individuals and
communities improve their health, by increasing their
knowledge or influencing their attitudes.
Another definition
Health education defined as teaching process, aiming to
changes in the health knowledge, attitude, and practice
of people.

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Health Educational Models: Are strategy for change
behavior, they are a framework to give educator
direction.
Health behavior: An action taken by a person to
maintain, attain, or regain good health to prevent illness.
Patient education:
Is a part of health education aimed to provide patient
with needed information and skills to use whatever
purpose is desired
▪ Health literacy:
Is an individual ability to read, understand and use
healthcare information to make decisions and follow
instructions for treatment.
Another definition: the ability of individuals to access
and use health information to make appropriate health
decisions and maintain basic health
▪ Information:
A collection of useful briefs or detailed, ideas, processes
data and theories that can be used for a certain period of
time.

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▪ Education:
A complex and planned learning experiences that aims
to bring about changes in cognitive (knowledge),
affective (attitude, belief, value) and psychomotor (skill)
domains of behavior.
▪ Communication:
The process of sharing ideas, information, knowledge,
and experience among people using different channels.
▪ Nutrition education:
Is education directed at the promotion of nutrition and
covers choice of food, food-preparation and storage of
food.
▪ Family life education:
Education of young people in a range of topics that
include family planning, child rearing and childcare and
responsible parenthood.
▪ Health promotion:
The process of enabling people to increase control over,
and to improve, their health.
▪ Perception:
Interpretation of the meaning given to sensory
information.

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▪ Knowledge:
It is storage of information in the brain. (learning facts
&gaining insight)

▪ Skills:
Performing any action (ability to do well(
▪ Attitudes:
Are relatively constant feelings, predispositions, or sets
of beliefs directed toward an idea, object, person or
situation. Put another way attitudes are beliefs with an
evaluative component. (Likes and dislikes)
▪ Values:
Are enduring beliefs or systems of beliefs regarding
whether a specific mode of conduct or end state of
behavior is personally or socially preferable (belief +
attitude)
▪ Motivation:
Is a combination of forces which initiate, direct and
sustain behavior towards goal (intrinsic or extrinsic
forces)

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▪ Telehealth nursing:
It is the delivery, management, and coordination of care
and services provided via telecommunications
technology within the domain of nursing.
▪ Telehealth:
It is the transmission of health-related services or
information over the telecommunications technology.
▪ Telemedicine:
It is the exchange of medical information from one site
to another through electronic communications.
Prevention:
Action taken to reduce the likelihood of some future
undesired event or condition or to increase the likelihood
of some future desired event or condition

▪ Blended learning

Is the use of traditional classroom teaching methods

together with the use of online learning for the same
students studying the same content in the same course.

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 Health Education

Out Line:-
Introduction
Definition of health education
Objectives of health education
Principles of health education
Content of health education
Techniques of heath education
Health education settings

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 1- Introduction
Health education is a critical part of improving the
health of populations through the promotion of healthy
behaviors. It focuses on building individuals’ capacities
to control and improve their own health through
educational, motivational, and skills-building activities
The object of health education is "to win friends and
influence people".
11- Definition of health education
WHO definition: Health education is any combination of
learning experiences designed to help individuals and
communities improve their health, by increasing their
knowledge or influencing their attitudes.
Anther definition Health education has been defined as
teaching process, aiming to changes in the health knowledge,
attitude, and practice of people .
111- Objectives of health education
a. Informing people or disseminate scientific knowledge about
prevention of disease and promotion of health.
b. Motivating people is more important than informing because
simply telling the people about health is not enough.

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 They must be motivated to change their habits and ways of
living because many of our daily health problems need change
of human behavior.
c. Guiding into action: health education should be conducted
by a variety of health, education and communication personnel
in a variety of settings starting with the physician.
d. To equip the people with skills, knowledge and attitudes to
enable them solve their health problems by their own actions
and effort.
e. To promote the development and proper use of health services.
IIIV - Principles of health education

1- Interest:
The health educator will have to bring about recognition
of the needs before he proceeds to tackle them.
2- Participation:
Participation is based on the psychological principle of
active learning; it is better them passive learning, group
discussion, and workshop. All of the previous is provide
opportunities for active living
3- Known to unknown:
In health education work, must proceed from

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 the known to the unknown i.e. start where the people are and
with what they understand and then proceed to new knowledge
4-Comprehension:
In health education must know the level of understanding
, education and literacy of people to whom the teaching is
directed. One barrier to communication is using words, which
cannot be understood. Teaching should be within the mental
capacity of the audience.
5-Reinforcement:
repetition at intervals is extremely useful and assists
comprehension and understanding.
6-Motivation:
Every person, there is a fundamental desire to learn.
Awaking this desire is called motivation
7- Learning by doing (practice and skills).
8- Communication:
Education is primarily a mother of communication.
The health educator must know how to communicate
with his audience.
9- Good human relation:
The health educator must be kind and sympathetic and
the people must accept him, as their real friend.

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10- Leaders:
Psychologists have shown and established that we
learn best from people whom we respect. In the field of
health education, we try to penetrate the community though
the local leaders.
Contents of health education:
1- Human biology:
Teach about structure and functions of the body and
how to keep physical fit. Also the need for exercise, rest
and sleep are tough. The effect of alcohol, smoking,
resuscitation and first aid.
2- Nutrition:
The aim of health education in nutrition is to guide
people to choose optimum and balanced diet who
contain nutrient necessary for energy growth and repair.
3- Hygiene
This has two aspects
a) Personal
b)Environmental
4-Mother and child health care as
Antenatal care
Post natal care

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 Hygienic care of mother and child.
Weaning
Family planning
Immunization
Prevention of accident among children.
5-Prevention of communicable disease
The aim of education in prevention of communicable
Is to prevention of infection and importance of immunization
6-Mental health
The aim of education in mental health is to help people to
mentally healthy and to prevent a mental breakdown.
7- Prevention of accident
Safety education should direct to the three main areas
homes, road and place of working
8- Use of health services
One of the declared aims of health education IS to inform
public about the health services that are available in the
VIII- Techniques of health education:
The techniques of health education are mainly the following:
I-Face to face heath education concept:
The educators are facing the recipients directly with
any intermediate.

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Situation:
One educator facing one recipient.
One educator facing multi recipients.
Multi educators are facing one recipient.
Multi educators are facing multi recipient.
Advantage of face to face methods:-
1- There is more involvement and participation of the recipient.
2- It is two way of communication.
3- It provides immediate and personal rewards for competence
of Punishment.
4- It is flexible (change topic according to recipient).
11- Mass Media:
This technique is refereed to when to when a health
education message is needed to be communicated to masses of
people. This mass is a heterogeneous group of people with
different needs and interests.
Types of mass media:
The following types of mass media could be used for
health education
Auditor media:
Microphone
Magnetic tap recording

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Visual media:
Book, booklets, pamphlets
Periodicals
Pictures, posters
Motion pictures and T.V
Advantage of mass media
1- It helps communication with great many of the population at
one time.
2- It attracts the listener attention and might persuade him to act.
Disadvantage:
1- They needs effort to produced good effect.
2- It is one-way communication so the recipient do
not participate in the educational process.
3- There is a great probability that the recipient feels that
ideas are strong to him and they are imposed upon him.
111- Community organization:
Community organization is one of the technique,
used in social work and adopted in health education.
Community organization is a process by which a community
identifies its needs or objectives orders or rank, these needs
or objectives develop the confidence and will to work at these
needs or objectives find the resources to deal with these needs

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or objectives
Steps of community organization:
1. Identifying needs or objectives.
2. Order or rank the needs or objectives.
3. Develop confidence and will to work on these
needs or objectives.
4. Finding of community leaders.
5. Forming an executive committee.
6. Finding the resources to deal with the patient.
7. Taking action.
Health education settings
Communities
Health care facilities
Work sites
Schools
Prisons

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 Health Education models
Outlines:
Introduction
Definition of Health educational models
Definition of health behavior
Health educational models:-
A-The rational model
B- Health Belief Model
C- The Trans theoretical model of change
D- The theory of planned behavior
E-PRECEDE – PROCEED model

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Introduction
Health behavior reflects a person's health beliefs.
Some common health behaviors are exercising
regularly, eating a balanced diet, and obtaining
Necessary inoculations.
Definition Health Educational Models : Are
strategy for change behavior , they are a framework
to give educator direction.
Definition of health behavior: An action taken by
a person to maintain, attain, or regain good health
to prevent illness.
Health educational models:-
A. The rational model
Within this model education strategies target
individuals and groups and strive to encourage
positive and prevent negative health behavior
choices. This model, also known as the knowledge,
attitudes, practices model (KAP) that increasing a
person’s knowledge will prompt a behavior change.
B- Health Belief Model
The Health Belief Model (HBM) was one of the
earliest behavior change models to explain human

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health decision-making and subsequent behavior .
It is a psychological model that attempts to explain
and predict health behaviors. This is done by
focusing on the attitudes and beliefs of individuals.
C- The trans theoretical model of change
Is an integrative health behavior change theory that
describes the process of how people change their
behavior. The central organizing construct in the
theory is stages of change, which are five distinct
stages of readiness to change behavior, ranging
from not ready to change (pre contemplation),
thinking about change (contemplation), preparing
to change (preparation), changing (action), and
maintaining the change (maintenance).
D- The theory of planned behavior
The theory of planned behavior asserts that
achieving and maintaining behavior change
requires intent to adopt a positive behavior or
abandon a negative one. The theory holds that
intent is influenced not only by the attitude toward
the behavior but also the perception of social norms
E-PRECEDE – PROCEED model:-

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- PRECEDE (Predisposing, Reinforcing, and
Enabling Constructs in Educational Diagnosis and
Evaluation) outlines a diagnostic planning process
to assist in the development of targeted and focused
public health programs
-PROCEED (Policy, Regulatory, and
Organizational Constructs in Educational and
Environmental Development) guides the
implementation and evaluation of the programs
designed using

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 Health Educator

Outlines:-

Introduction

Definition of Health Educator

Characteristics of Health educator

Essential Responsibilities and Duties

Qualifications

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Introduction

The health education field is that multidisciplinary

practice which is concerned with
designing ,implementing And evaluating educational
programs that enable individuals , groups ,organizations
and communities to play active roles in achieving ,
protecting and sustaining health.

Definition of Health Educator

Health Educator Is participate in promoting,

maintaining, and improving individual and community
health; to assess individual and community needs; plan,
implement and evaluate effective health education and
promotion programs; provide and communicate health
education information
Characteristics of Health educator

personal Characteristics
◼ Self confidence .
◼ Cheerful ,optimistic.
◼ Has a sense of humor.
◼ Good observer .
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 ◼ Patient .
◼ Fair and objective .
◼ Has physical energy and vitality
◼ Sociable .
◼ Provocateur .
◼ Flexible .
◼ Respect his learners .
◼ Anticipate individual needs .
◼ Perceiving value of time .
◼ Honest .

Professional characteristics:
◼ Competent :-
Health educator should be :-
✓ Knowledgeable and skillful .
✓ Decision-maker : decide what is important to
teach .
✓ Choose appropriate learning material
✓ Provide appropriate learning environment.
✓ Teach home management of special problems.
✓ Monitor learners understanding by asking
questions and provide feedback.

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 ▪ Caring :
✓ Have sympathy with learner .
✓ Provide encouragement .
✓ Recognize learners needs and concerns .
✓ Show sensitivity to patient mood

▪ Communication :
Health educator should communicate effectively by
using verbal &non verbal communication.
Non-verbal communication include :
✓ Gesture or body language :(The use of body
movement to communicate as head nodding ,
finger pointing ) .
✓ Facial expression : Face is the personality window
. It express large messages as anger , fair , surprise
…..
✓ Eye contact
✓ Paralanguage include:

-Voice Volume :high or low

-Speaking rate : Is how fast or slow you are speaking

✓ Proximiecs :

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 -Personal space . It include the distance between
sender and receiver as : Intimate , personal ,and
social zone.
- Touch : It is an important mean ,it conveys
interest ,warmth, and reassurance but should based
on culture.
- Culture artifacts .
Verbal communication
This consist of written or spoken words
.communication
Techniques include :
✓ Active listening.
✓ Using silence.
✓ Broad opening : ex. "What are doing today?".
✓ Use open ended questions. It is open field for
communication.
✓ Reflection: reflect what he said.
✓ Restatement: repeating the spoken words as it is.
✓ Paraphrasing: repeating the spoken words in the
same meaning using another words.
✓ Clarification: ex. "Tell me more about that".
✓ Focusing : make stress on important points.

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Essential Responsibilities and Duties

Responsibility 1.Assessing individual and community

needs for health education
1– Obtain health-related data about social and cultural
environments, growth and development factors,
needs and interests

2 – Distinguish between behavior that fosters and that

which hinders wellbeing

3 – Infer needs for health education on the basis of

obtained data
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Responsibility 2.Planning effective health education
programs
1 – Recruit community organizations, resource
people and potential participants for support and
assistance in program planning

2 – Develop a logical scope and sequence plan for a

health education program

3– Formulate appropriate and measurable program

objectives

4– Design educational programs consistent with

specified program objectives

Responsibility 3.Implementing health education

programs
1 – Exhibit competence in carrying out planned

educational programs

2 – Infer enabling objectives as needed to

implement instructional programs in specified
settings

3 – Select methods and media best suited to

implement program plans for specific learners

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 4 – Monitor educational programs, adjusting
objectives and activities as necessary

Responsibility 4.Evaluating effectiveness of health

education programs
1– Develop plans to assess achievement of program

objectives

2 – Carry out evaluation plans

3 – Interpret results of program evaluation

4 – Infer implications from findings for future

program planning
Responsibility 5.Coordinating provision of health
education services
1– Develop a plan for coordinating health-education
services
2 – Facilitate cooperation between and among levels
of program personnel
3 – Formulate practical modes of collaboration among
health agencies and organizations
4 – Organize in-service training programs for
teachers, volunteers, and other interested personnel

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Responsibility 6.Acting as a resource person in
health education
1– Use computerized health information retrieval
systems effectively
2 – Establish effective consultative relationships with
those requesting assistance in solving health-
related problems
3 – Interpret and respond to requests for health
information
4 – Select effective educational resource materials for
dissemination
Responsibility 7.Communicating health and health
education needs, concerns, and resources
1 – Interpret concepts, purposes, and theories of
health education
2 – Predict the impact of societal value systems on
health education programs
3 – Select a range of communication methods and
techniques for providing health information
4 – Foster communication between health-care
providers and consumers
Qualifications of Health Educator

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 1. Knowledge of:

• Basic principles and practices of community health

promotion programming, social marketing,
evaluation, and coalition building
• Electronic communications technology
• Current public health issues including, but not
limited to, wellness, nutrition, tobacco control,
physical fitness, injury prevention and preventive
health care
• Pertinent Federal, State, and local laws, codes, and
regulations

2. Ability to:

• Learn local public health issues including wellness,

nutrition, tobacco, physical fitness, and preventive
health care
• Assist with the coordination and implementation of
assigned health education program
• Learn and apply Federal, State, and local policies,
procedures, laws and regulations
• Gain cooperation through discussion and
persuasion

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 • Communicate public health issues clearly and
concisely, both orally and in writing
• Establish and maintain cooperative working
relationships with those contacted in the course of
work

3. Training and Experience Guidelines

Training:

• Equivalent to a bachelor's degree from an

accredited college or university with major course
work in community health education, public health
education, communications, or a related field.
C.H.E.S. (Community Health Education Specialist)
certification is highly desirable

Experience:

• No experience required

Health Educator II
In addition to the qualifications for Health Educator
I: Knowledge of:

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 • Advanced principles and practices of community
health promotion programming, social marketing,
evaluation, and coalition building
• Current public health issues including, but not
limited to, wellness, nutrition, tobacco control
,unintentional injury prevention, physical fitness,
and preventive health care
• Electronic communications technology
• Pertinent Federal, State, and local laws, codes, and
regulations

Ability to:

• Develop and administer community health

education programs
• Coordinate and implement the assigned health
education program
• Analyze problems; identify alternative solutions,
project consequences of proposed actions and
implement programs in support of program goals
• Interpret and apply Federal, State, and local
policies, procedures, laws and regulations
• Develop community partnerships and coalitions
• Communicate public health issues clearly and
concisely, both orally and in writing
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 • Act as a public health advocate
• Establish and maintain cooperative working
relationships with those contacted in the course of
work

Training and Experience Guidelines

Training:

• Equivalent to a bachelor's degree from an

accredited college or university with major course
work in community health education, public health
education, communications, or a related field.
C.H.E.S. (Community Health Education Specialist)
certification is highly desirable
• Experience:
• Two years of community health education
experience

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 Methods of health education

Outlines

Introduction
Definition of methods of health education
Common health education methods
Types of health education
Individual methods
Group method,
Mass media method

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Introduction

Methods of health education are generic

descriptions of how change is to be brought about
within the target group. While planning health
education programs, it is not that any method can be
used (as delivering lectures to all concerned) but rather
the most appropriate method most suited for the topic
and the target audience should be selected. The methods
which have proved to be most effective are those which
take into account the interests of the learner and which
offer him the opportunity of participating actively in the
learning process.
Definition of educational methods

They are the techniques or ways in which series of

activities are carried out to communicate ideas,
information and develops necessary skills and attitudes.

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 Commonly Used Health Education Methods

informal methods Formal methods

- health talk - Conference

- lecture- discussion - workshop
- brainstorming - seminar
- group discussion - Panel discussion
- Buzz group - Symposium
- demonstration - Inquiry Learning
- Role play - Simulation (an approach in
- Drama which students
- Case studies formulate and test
- Traditional media their own
hypothesis)

Types of health education (HE) method

1- individual HE Method

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 This method involves person to person or faces to
face communication which provides maximum
opportunity for two way flow of idea, knowledge and
information. Adequate interaction between the health
educator and his client help provide health education
successfully resulting in attitude and expected behavior
change.

Way of successful individual HE method is

counselling and interview.

For example
when an individual come to the dental clinic or the
health center because of illness , the opportinuity should
be used to educate him on matters of interest such as the
cause and nature of his illness, its prevention, beneficial,
diets, oral hygien etc.
This approach can also be used by public health
personnel, since they will be visiting home and
interacting with individual and family member.
2- group HE method

An ideal group may consist of 6- 12 members

depending upon situation. This method is very effective

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"two way" communication of educating the community,
promoting behavioral change, influences opinion,
develop critical thinking and increase motivation.

In spite of the advantage of individual methods for

health education cannot be use due to the time limitation
and shortage of manpower. So it will be more
practicable for him to provide education in group as
well.

Group method include-

• Group discussion, • Brain storming,

• Demonstration, • Panel discussion,
• Mini-lecture • Role play,
• Problem solving • Field trip/ educational
• Workshop tour/ campaign
• Seminar • Symposium.

3- Mass Media Method

This method is especially meant for a large number of

heterogeneous people. Mass method includes-

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 • Lecture,
• Exhibition,
• Audio aid – radio cassette player,
• Video aid- posters, pamphlets, flip chart, flannel
graph, butte tin board etc.
• Audio- visual aids such as television, documentary
films& sound, videotape movies.
• health information booklets , internet

All Terms in Health Education Methods

Items Definition
lecture Carefully prepared oral presentation of facts,
organized thoughts and ideas by a qualified
person.
brain is a group creativity technique by which efforts
storming are made to find a conclusion for a specific
problem by gathering a list of ideas
spontaneously contributed by members.
or it is a means of elicting from the participants
their ideas and solution on health issues
simulation Is an artificial representation of a real world
process to achieve educational goals through

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 experiential learning.
role play It is a type of drama in a simplified manner. It
portrays expected behavior of people.
demonstration Is carefully prepared presentation to show how to
perform a skill or procedure.
panel composed of 4-8 speakers who are qualified to
discussion talk and discuss about a problem or a topic in
front of a large group or audience
symposium Series of speeches on a selected subjects.Each
person or expert present an aspect of the subject
briefly.
Buzz group A large group is divided into small groups not
more than 10-12 members in each each group &
they are given a time to discuss the problem.
work shop consists of meetings, usually four or more with
the emphasis on individual work, wehre
participant get fully involved in the learning
process under expert guidance
Conference It composed of two to fifty persons representing
several organizations, departments. They gather
information and discuss mutual problems with a
reasonable solution as the desirable end.

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Seminar A group of persons gathered for the purpose of
studying a subject under the leadership of an
expert or learned person. It involves paper
reading on a theme and followed by group
discussion to clarify the complex aspects of the
theme

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 Teaching aids

Outlines:-

Definition of teaching aids

Needs for teaching aids
Classification of teaching aids
Some examples of teaching aids
The teacher as teaching aids
How to use of teaching aids
Advantages of teaching aids
Characteristics of good teaching aids

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Definition of teaching aids?

Teaching aids (TAs): Teaching aids are objects

(such as a book, picture, or map) or device (such as a
DVD or computer) used by a teacher to enhance or
enliven classroom instruction. They could be
audiovisual teaching aids such as videos and guest
lectures or tactile like 3D models.

Teaching aids are tools that teacher use them in the

classroom such as flash cards, maps, cassette&
blackboard

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Needs for teaching aids

reinforce what you are saying,

ensure that your point is understood,

signal what is important/essential,

enable students to visualise or experience

something that is impractical to see or do in real
life,

engage students’ other senses in the learning

process,

facilitate different learning styles.

proper use of teaching aids helps to retain more

concepts permanently.

Students can learn better when they are motivated

properly through different teaching aids

Teaching aids develop the proper image when the

students see, hear, taste and smell properly.

Teaching aids provide complete example for

conceptual thinking.

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Types and classification of teaching aids:

Classification 1

Non-electronic – Chalkboards, flip boards, slates,

photos, telescopes,
Electronic – Powerpoint slideshows, videos, Augmented
reality/Virtual reality goggles, AV-room equipment

Classification 2:

Visual aids
The aids which use sense of vision are called visual aids.
For example: actual objects, models, pictures, charts,
maps, chalkboard, overhead projector, slides. etc.Out of
these blackboard and chalk are the commonest ones.
Audio Aids:
The Aids that involve the sense of hearing are called
Audio aids. For example:- radio, tape recorder,
gramophone.
Audio-Visual Aids:
The aids which involve the sense of vision as well as
hearing are called Audio-Visual aids. For example:-
television, Projector, etc.

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Some examples of teaching aids:-

WHITE-/BLACKBOARD

Advantages

No advanced preparation required,

except when displaying a complex table/chart/
diagram.
Technology is not dependent on electricity or
other possible glitches.
Can be used by students for problem-solving, etc.

Disadvantages

Time-consuming if you have a lot to write.

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 Handwriting may be difficult to read (legibility,
size, glare, etc.).
Turn your back on audience.
Cleaning the board (chalk dust, permanent marker,
etc.)
Can’t go back to something you’ve erased.

OVERHEAD PROJECTOR

Advantages

Allows you to prepare all your slides in advance.

Particularly suited for complex diagrams, charts
and illustrations.
Can build up information point-by-point through
the use of overlays.
Don’t have to turn your back on the audience.

Disadvantages

A blown bulb or power failure can spoil all your

hard work.
Image quality can also be a problem.
Can be disorienting to manipulate transparencies
on projector plate.

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POWER POINT PRESENTATION

Advantages

Good for large rooms and audiences

Can be action oriented or words oriented
Allows for reference back to previous slides

Disadvantages

Expensive
Can be difficult to produce – easier with
computer graphics
Room must be darkened somewhat
Requires equipment and knowledge of that
equipment
Relatively portable
Order easily arranged

OTHER MEDIA AUDIO TAPES or CDs

When to USE:

Particularly suited for language learning, media

studies, English literature, etc.

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 Valuable when referring to recorded historical
events (e.g. Martin Luther King’s “I have a
dream” speech).
Background music can also be played before
class starts and during group activities.

TIPS

Check the room and equipment beforehand.

Can it be heard from the back of the room?
Find the right spot on the tape/CD and queue it
up in advance.
Don’t play more than a few minutes of audio at
one time.
Break up longer clips into segments,
interspersed with discussion or other activities.

OTHER MEDIA VIDEO TAPES or DVDs

When to USE:

Adds a dimension not available through audio

alone - helps students to visualise.
Essential when illustrating things that are
impractical to do in real life.

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 Particularly suited for language learning, media
studies, engineering, etc.
Valuable when referring to recorded historical
events.

TIPS

Same as for CDs/audio tapes

Check equipment beforehand.

Can images be seen from the back of the room?

Queue up the tape in advance.

Break viewing into short segments, interspersed

with discussion or activities.

The teacher as a teaching aid - In my experience as a

teacher I have discovered that I can involve students
more in classroom discussion and activities if I follow
certain simple steps.

Movement
Use body language
Eye contact
Gesture
Facial expression
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 Speech
Student talk
Names

How to use teaching ads

Teaching aids should be simple and brief

Teaching aids should be related to the objects of
teaching
Teaching aids should be big door to be seen by all
the students
Teaching aids should be prepared and planned in
advance
Teaching aids should be properly selected
according to the physical and mental level of the
student
Teaching aids should be meaningful and interesting
Teaching aids should be colorful and should have
direct impact on the lesson
Teacher must use proper Teaching aids according
to the interest of the student.
Teaching aids must be ( well prepared, well
presented, readable, legible, visible to all,
appropriate format for room and audience size
51
 Teaching aids must be relevant, pertinent to topic,
up-to-date, consistent with local protocols.
Advantages of teaching aids
Supplement in verbal instructions
Teaching aids make learning permanent.
Teaching aids provide variety
Teaching aids are helpful in attracting attention to
the students
Teaching aids saves time and energy
Teaching aids encourages healthy classroom
interaction
Teaching aids are helpful in creating positive
environment for discipline
Teaching aids are helpful in meeting individual
differences

Characteristics of good teaching aids

A few Characteristics of good teaching aids are as

follows:-

Teaching aids are large enough to be seen by the

students for whom they are used.

52
Teaching aids are meaningful and they always
stand to serve a useful purpose.
Teaching aids are simple, cheap and may be
improvised.
Teaching aids are accurate and realistic.
Teaching aids are according to the mental level of
the learners
Teaching aids helps in realization of stipulated
learning objects.
Teaching aids are really very useful and can be
used in many lessons and at different class levels

53
 Health promotion

Outlines:-

Definition of health promotion

Objectives of health promotion

Health Promotion Strategies according to WHO:-

Component of health promotion

54
 ✓ Definition of health promotion:-
is the process of enabling people to increase
control over & improve their health by
developing their resources to maintain or
enhance well being.
✓ OR Health promotion: Refers to programs or
interventions that focus on behavior changes
directed toward improved health and well-being of
individuals, groups, communities, and nations in
relation to their environment.
✓ Definition of health promoting:- is an action
for health using knowledge, communication &
understanding

Objectives of health promotion:-

1. Increase quality and years of healthy life
2. Maintain function
3. Eliminate health disparities
4. Increase independency
5. Improve (enhance) quality of life
6. Extend life expectancy → ↓ premature
mortality caused by chronic& acute
diseases
55
Health Promotion Strategies according to WHO:-

1. Advocacy
2. Mediation
3. Empowerment (Enabling)

1. Advocacy for Health is a combination of individual

and social actions designed to gain political
commitment, policy support, social acceptance and
systems support for a particular health goal or program.
Advocacy can take many forms including the use of the
mass media and multi-media, direct political lobbying,
and community mobilization.

2. Mediation: In health promotion, a process through

which the different interests (personal, social, economic)
of individuals and communities, and different sectors
(public and private) are reconciled in ways that promote
and protect health.

3. Empowerment (Enabling): In health promotion,

enabling means taking action in partnership with
individuals or groups to empower them, through the
mobilization of human and material resources, to
promote and protect their health.
56
Component of health promotion
1. Exercise
2. Nutrition
3. Rest & sleep
4. Periodic medical check up
5. Health related behavior
6. Spiritual well-being
7. Psychosocial well-being

1- Exercise

Psychological

Benefits
of
exercise

Physical Social

Physical benefits of exercise

1. Increase consumption of body fat

57
 2. Improve cardio-vascular capacity( by↑ blood
flow----- keep tissue healthy
3. Control hypertension& blood sugar
4. Improve respiratory function
5. Improve joint flexibility
6. Improve pattern of sleep & rest
7. ↑ independency
8. Improve sense of well –being & relaxation
9. Maintain mind’s function
10. Promote sense of normality
11. Peristaltic movement

Psychological benefits of exercise

1. Improve mood state
2. Improve self-image
3. Reduce stress
4. Enhance sleep
5. Improve depressive state of elderly
Social benefits of exercise
Improve social interaction & relation with other

Types of exercise:

A-Isotonic exercise:
58
 This type of exercise is also called dynamic or
cardiovascular exercise, and it describes the kind of
activities where you move the joints and muscles in your
arms or legs. This is usually the best kind of exercise for
people with a heart condition, but you need to check
with your specialist before you do it for the first time.

Isotonic exercise includes:

• Leisurely walking.
• Swimming.
• Cycling.
• Walking fast.
• Dancing.

Some heart conditions mean that you might not be

able to do very high-intensity isotonic activities like
basketball, triathlon, competitive level swimming,
cycling or running, so make sure you check with your
specialist.

B-Isometric exercise:

This type of exercise is also called static, weight or

resistance exercise. It doesn’t involve very much joint

59
movement as it is mostly muscle work. Often people
with heart conditions need to avoid some of these
exercises because they put a strain on your heart and
blood vessels. Check with your specialist before you
join a gym or start doing any of these.

Isometric exercise includes:

• Weight-lifting.
• Rock-climbing.
• Boxing, wrestling.
• Martial arts.

2- Nutrition
It is neglected especially those living alone or with
low income.

Factors affecting nutritional status:

1. Psychosocial factors
2. Economic factors
3. Cultural factors

Psychosocial factors
• Depression is common ( losses, death,
retirement, change of body appearance,

60
 impaired vision &poor physical fitness) this
will lead to lack of interest in eating& anorexia
and ↓ food intake.
• Living alone also will lead to lack of incentive
to cook &eat.
Economic Factors
• Low income
• Limited access to food and food choices
• Inadequate facilities to food storage and
preparation
Cultural factors
• Eating habits may miss certain food group as
vegetarians.
3- Rest& sleep
✓ Person spend 1/3 of his life in sleep
✓ Sleep is time for cell growth& repair
✓ Elderly need 5-7 hrs at night

Importance of Rest& sleep:

• Conserve energy
• Provide organ respite (rest)

61
 • Restore the mental alertness& neurological
efficiency
• Relieve tension
• Emerge feeling of well being

Nursing measures adopted to promote sleep

1. Engage in exercise program
2. Avoid exercise within 3-4 hr. of bedtime.
3. Spend time out door in the sunlight each day
but avoid period between 12 PM to 3 PM
sunshine exposure.
4. Engage in relaxing activities near bedtime.
5. Avoid tobacco at bedtime
6. Avoid drink any caffeinated beverages before
midafternoon.
7. Limit fluid intake after the dinner hour if
nocturia is a problem.
8. Limit daytime naps to 30 minutes or less.
9. Avoid using the bed for watching TV, writing
bills, and reading.

4- Periodic medical examination

o Importance of Periodic medical examination:
62
 o Assess the level of well-being
o Detect early signs of disease
o Educate client how to promote his health
o Reinforce + ve promoting & protecting
behaviors
o If examination done at home, it permit
evaluation of environment ( hazards care
giver…)
Types of health screening

Health screening Period

Bl. P Each Dr. visit or 3-6 months

Ht & wt Periodically as part of

comprehensive physical
examination

Dental check up Once / year( annually)

Fecal occult blood& ( annually)

sigmoidoscopy

Vision including Every 2 years

glaucoma test

Hearing Evaluate periodically

63
 Cholesterol level Every 5 years

Cancer screening Annually

Mammography for 1-2 years

women under 70
years

5- High Risk Behavior

It is behavior that damage physical health.
It includes:
• Smoking
• Over counter medication (multiple
medications)
• Caffeine

Smoking:

• Nicotine & toxic substances in cigarette has impact on

detoxication process in the body------- cell damage&
variety of diseases as cancer, respiratory, CVD, ↑ risk of
osteoporosis.
• Cessation of smoking improves cerebral blood flow&
↑ pulmonary function.

64
Multiple medications:

• Older people consume many medications--------

↑adverse drug reaction.
• The most common over the counter medication:
Analgesics, laxatives& antacids followed by cough
products, eye wash& vitamins.

Caffeine:

• Found in coffee, tea, soft drinks, chocolate.

• It is mood elevator.
• It stimulates sympathetic nervous system.
• ↑Motor activity.
• ↑ Muscle capacity & alertness.
• ↑ Rapid pulse.
• ↑ Calcium excretion.

7- Spiritual Well- being

Spiritual well-being is the practice and philosophy of
the integral aspects of mental, emotional and overall
wellbeing.

• Spiritual well-being is a state in which the positive

aspects of spirituality are experienced, incorporated and
65
lived by the individual and reflected into ones
environment.

Signs of spiritual distress:

• Doubt.
• Despair.
• Guilt.
• Boredom.
• Expression of anger toward god.

Measures to increase Spiritual well being

✓ Identify ways that believes give meaning to
life
✓ Use problem solving to solve any conflict
related to spirituality
✓ Meeting with religious man at regular
intervals
✓ Presence of religious literatures in the
immediate environment such as Quran on
beside table
✓ Reading in religious books & praying
✓ Discuss role of spirituality in one’s life

66
Role of the nurse in health promotion:-
1. Assessment physical health, Psychosocial Well-
being, lifestyle pattern, hobbies, high risk
behaviors, knowledge, believes& attitudes that
affect health & wellbeing.
2. Assess health needs
3. Assess social , environmental & cultural
influences on health behaviors
4. Lifestyle modifications is a comprehensive
approach for effective change in heath
promotion behaviors
5. Nurse role should directed toward helping
elderly to cope with his function level ------
delay disabilities & impairments.
6. Nurse identify environmental hazards & make
necessary modifications
7. Identify social needs & encourage participation
& social support groups.
8. Nurse should inform elderly & caregivers about
aging process, common disorders & disabilities
, different services available

67
9. Encourage elderly to take better care to them,
avoid high risk behaviors,& hazards affecting
their health.
10. Regular and continuous evaluation is
important aspect of nurse’s role.

68
 Communication

Outlines:

Introduction.

Definition.

Component or elements of communication.

Types of communication.

o Verbal

o Nonverbal

Barriers of communication.

Measures to improve communication

Reference.

69
 Introduction:

Communication is an important behavioral skill that

allows us to survive in and interact with our world.
Through our ability to communicate, we express our
needs and wishes, understand others’ needs and wishes,
negotiate adversity, and convey our feelings to others.
We rely on our ability to communicate effectively to
gather and share information as well as to build
relationships with patient and families. This information
should promote development of the skills needed to
communicate effectively and promote optimal health for
older adults.

Definition of communication:

 Communication is two –way process concerned with

conveying a message or an idea between two or more
individual, one person is sender and one is the receiver
of message.

 Communication is the process or means by which an

individual relates experiences, ideas, knowledge, and
feelings to another

70
The communication process:

Communication occurs as a sequence of events. The

process consists of seven basic parts that work together
to result in the transference and understanding of
meaning.
1. A message
The first part of communication process is a message,
which is an expression of the purpose of communication.
Without the message, there can be no communication.
2. A sender
Sender is the person (or persons) conveying a message.
3. A receiver

71
A receiver is the person (or persons) to whom the
message is directed and who the intended recipient of the
message.
Encoding
Encoding which refers to the sender's conversion of the
message into symbolic form. This involves how the
sender translates the message to the receiver.
4. A channel
A channel or medium through which the sender conveys
the message the channel may be a written, spoken, or
nonverbal expression. Examples include an e-mail
stating a request, a report providing information, a
written care plan, a verbal request for clarification, or a
facial expression indicating confusion.
5. Decoding
Decoding which is the sixth part of the communication
process. The receiver's ability to decode the message is
influenced by the knowledge of the topic, skills in
reading and listening, attitudes, and sociocultural values.
6. A feedback loop

72
A feedback loop which refers to the receivers indicating
that the message has been understood (decoded) in the
way that the sender intended (encoded).
Types of communication

Communication can be classified in the following

different ways.
• Verbal communication:-
The basis of communication in the interaction between
people. Some of the key components of verbal
communication are sound, words, speaking, and
language.

Characteristics of verbal communication

1. Verbal or oral communication is the use of language to
convey message.
2. It implies, attitudes, thought, feeling that
communicated through spoken or written words which
be clear, concise, purposeful, and direct.
3. Verbal communication is largely conscious, because
people choose the words they use. The words used very
among individual according to culture, socioeconomic
background, age and education.

73
4. The sender of verbal communication should choose the
right time and environment to convey message.

The effective verbal communication:

Using TACTFUL conversations:

T= thinking before you speak.

A= apologize quickly when you blunder.

C= converse, don't compete.

T= time your comments.

F= focus on behavior not on personality.

U= uncover hidden feelings.

L= listen for feedback.

• None verbal communication:-

Is the process of transmitting message without spoken
words, sometimes called body language? Message can
be communicated through facial expression, gestures and
posture; many include the space we use around us.
Object communication includes clothing, hairstyles,
decoration, and shoes.
Elements of nonverbal communication:

74
1- Personal appearance:

It include physical characteristic. Manner of' dress and

grooming, make up, jewelry, hairstyle, This factors help
in communicate personality, social status, occupation
and religion first impression are based on appearance so
the nurse can develop general impression about client
wellbeing, and emotional status.

2- Facial expression:

Facial expressions are the most important source of non-

verbal communication. They generally communicate
emotions e.g. Anger, sadness, joy, fear and surprise that
reveal little about what they are thinking or feeling.
Some people are extremely expressive, and other is
masked.
3- Eye contact:

Eye contact is another very important cue in

communication.

- maintaining eye contact during conversation show

respect and willingness to listen.

- Lake of eye contact may indicate anxiety, discomfort

75
or that person is avoiding communication.

4-Posture and gait:

The way of people sitting, standing and move reflect

altitude, emotions and self-concept. E.G." erect posture
and quick communicate indicates confidence and
wellbeing; slow shuffling gait indicate depression,
fatigue or illness.

5- Para language.

Is the non-verbal aspect of verbal communication. It

includes tone of voice, volume "loudly, softy" and
sound" e.g. Crying, gasping, singing".

E.g. Speaking loudly may indicate feeling of anger.

Speaking softly may indicate a concern.

6- Touch:

It is a powerful tool that conveys either negative or

positive expression, therapeutic use of touch is effective
in conveying non-verbal message and feeling of love, it
include hand shaking, hugging, holding hands and
affected by culture.

7- Gesture:
76
Body gestures provide clues about persons and about
how they feel toward others. Hand gesture can
communicate anxiety. Indifference and inpatient, Body
position gives cues about how open a person is to
another person, or how interesting and attractive one
person is to another. E.g. depressed patient may take
fetal position.

8- Personal space (proximities):

Personal space refers to an area with invisible

boundaries surrounding the person's body, that other is
expected not to invade.

The range of personal space is culturally learned as well

as individually determined, based on personal comfort.
Also it depends on nature of relationship and situation.
Communication Barriers
A) Barriers related to sender level:
1-Does not know the subject.
2-Cannot communicate the message.
3-Does not formulate clearly the objectives.
4-Does not formulate well the message.
5-Does not choose the language of the receptor.

77
6-Does not adapt the tone of voice.
B) Barriers related to message level:
1-Difficult words.
2-Is not interested to the receiver.
3-Is not relating to the stated objectives.
4-Unclear confusing not brief.
C) Barriers related to channel level:
1-Noise.
2-Not adapted to the message transmission.
3-Not accessible to the receptor.
D) Barriers related to the receiver level:
1- Indifferent to the message.
2- Could not decode the message.
3- Cannot receive the message.
4- Poor listening condition.
E) Barriers related to environment.
1-If the location of communication is overcrowded.
2-If location is noisy.
3-If the place is threatened &discomfort.
4-If climate is too cold or too hot.

Measures to improve communication:

• Maintain active listening. E.g. maintain eye contact,

78
give full attention.
• Accept the patient's mode of communication with
appropriate response, conveying interest and
understanding.
• Minimize your verbal participation; so the patient will
have the chance of leading the verbalization.
• Accept periods of silence.
• Avoid offering reassurance too quickly, changing the
patient's conversation topic or defending.
• Provide the amount of information the person could
handle rather than the amount you might won't to give.
• Be ready to give feedback.
• Utilize effective and therapeutic technique of
communication according to the situation.
• Provide right climate and environment

79
 health and human behavior

outline:-

Introduction
Definition of behaviors and other related terms
Examples of behaviors promoting health and
preventing diseases
Levels of diseases prevention ( past and advanced)
Factors affecting behavior
Predisposing factors
Enabling factors
Reinforcing factors
Healthy Behaviors for a Healthier Lifestyle

80
Introduction

Human behavior is among the major determinants of the

health of individuals, families or communities. Healthy
behaviors contribute to the overall health of individuals
and communities and unhealthy behaviors adversely
affect the quality of life people at different levels. The
promotion of health and prevention of diseases will
usually involve some changes in lifestyles or human
behavior.

Definition of behaviors and other related terms

Behavior is an action that has a specific frequency,

duration and purpose whether conscious or unconscious.
People stay healthy or become ill often as a result of
their own action or behavior

The following are examples of how peoples actions can

affect health:

• Feeding children with bottle put them at risk of

diahrrhea
• Defecating in an open field will lead to parasitic
infection

81
 • Unsafe sex predisposes people to unwanted
pregnancy. Hiv\AIDS and other STDs

N.B: The word actions, practices and behaviors are

different words of the same thing

Lifestyle: refers to the collection of behaviors that

make up a persons way of life- including diet, clothing,
family life, housing and work.

Customs: it presents the group behavior. It is the

pattern of action shared by some of all members of the
society.

Traditions: are behaviors that have been carried

out for along time and handed down from parents of
children

Culture: is the whole complex of knowledge,

attitude, norms, belief, values, habits, customs, traditions
and any other capabilities and skills acquired by man as
a member of society.

Examples of behaviors promoting health and

preventing diseases

82
Healthy behaviors: actions that healthy people
undertake to keep themselves or others healthy and
prevent disease

(Good nutrition, Breast feeding, reduction of health

damaging behaviors like smoking)

utilization behavior:- utilization of health services such

as antenatal care, child health, immunization, family
planning….etc

illness behavior: recognition of early symptoms and

self- referral for treatment.

Compliance behaviors: following a course of

prescribed drugs such as for tuberculosis.

Rehabilitation behaviors: what people need to do after

a serious illnesss to prevent further disability.

Levels of disease prevention (past and recent)

Prevention, as it relates to health, is really about

avoiding disease before it starts. It has been defined as
the plans for, and the measures taken, to prevent the
onset of a disease or other health problem before the

83
occurrence of the undesirable health event. There are
three distinct levels of prevention.

1 Primary prevention

Primary prevention — those preventive measures that

prevent the onset of illness or injury before the disease
process begins. Examples include immunization (Figure
4.1) and taking regular exercise.

2 Secondary prevention

Secondary prevention — those preventive measures

that lead to early diagnosis and prompt treatment of a
disease, illness or injury to prevent more severe
problems developing. Here health educators such as
Health Extension Practitioners can help individuals
acquire the skills of detecting diseases in their early
stages. Examples include screening for high blood
pressure and breast self-examination; you will learn
about both of these in the Module on Non-
Communicable Diseases, Emergency Care and Mental
Health.

84
3 Tertiary prevention

Tertiary prevention — those preventive measures

aimed at rehabilitation following significant illness. At
this level Health Extension Practitioners can work to
retrain, re-educate and rehabilitate people who have
already developed an impairment or disability.

85
86
Recent levels of prevention:-

1-Primordial prevention:

In primordial prevention, efforts are directed

towards discouraging elderly from adopting harmful
lifestyles.

2-Primary level of prevention:

(Health promotion, disease prevention/ specific

protection) includes all activities that actively promote
optimal health and prevent disease through specific
prevention.

Primary prevention aimed at healthy individuals, to

prevent disease from occurring. Examples include:

• Vaccinations.
• Adopting a healthy lifestyle. For example: Diet,
Weight, Exercise, avoidance of smoking.

3-Secondary prevention:

This is aimed at patients with an existing pathology, to

reduce the risk of recurrence or progression. For
example:
87
• Aspirin in arterial disease.
• Beta-blockers and angiogenesis-converting enzyme
(ACE) inhibitors after myocardial infarction.
• Smoking cessation in Chronic Obstructive
Pulmonary Disease (COPD) and established arterial
disease.

4-Tertiary prevention:

Efforts are used to manage clinical diseases in order to

prevent them from progressing or to avoid complications
of the disease, as when beta blockers are used to help
remodel the heart in congestive heart failure.

5-Quaternary prevention:

Methods to avoid results of unnecessary or

excessive interventions in the health system. In other
words, not spending money and effort on things that
don’t work.

Factors affecting behavior

Three factors affecting behavior can be identified:

1. Predisposing factors

88
 2. Enabling factors
3. Reinforcing factors.

1. Predisposing factors

Predisposing factors are those characteristics of a

person or population that motivate behavior before the
occurrence of that behavior. Peoples’ knowledge,
beliefs, values and attitudes are predisposing factors and
always affect the way they behave.

Knowledge

Knowledge is usually needed but is not enough on its

own for individuals or groups to change their behavior.
At least some awareness of health needs and behavior
that would address that need is required.

Usually, however, for behavior change some additional

motivation is required. For example, even if a mother
knows in general about using oral rehydration salts
(ORS) when her child is dehydrated due to diarrhea, she
may need a reinforcing message from you before she
will actually use them.

89
Beliefs

Beliefs are convictions that something is real or true.

Statements of belief about health include such negative
comments as, ‘I don’t believe that exercising daily will
improve my health’. More positive health beliefs might
include statements such as, ‘If I use an insecticide
treated bed net at night I will probably not get malaria.’

Often a potent motivator related to beliefs is fear. The

fear results from beliefs about the severity of the health
threat and one’s susceptibility to it, along with a feeling
of hopelessness or helplessness to do anything about the
threat.

Values

Values are the moral and ethical reasons or justifications

that people use to justify their actions. They determine
whether people consider various health-related
behaviors to be right or wrong.

Of interest is the fact that people often hold conflicting

values. For example, a teenage male may place a high
value on living a long life; at the same time, he may

90
engage in risky behaviors such as chewing khat and
drinking alcohol.

Attitudes

Attitudes are relatively constant feelings directed

toward something or someone that contains a judgment
about whether that something or someone is good or
bad. Attitudes can always be categorized as positive or
negative.

For example, a woman may feel that using

contraception is unacceptable. Attitudes differ from
beliefs in that they always include some evaluation of
the person, object or action.

Self-efficacy

The most important predisposing factor for self-

regulating one’s behavior is seen to be self-efficacy, that
is the person’s perception of how successful he or she
can be in performing a particular behavior. Self-efficacy
is learning why particular behaviors are harmful or
helpful. It includes learning how to modify one’s
behavior, which is a prerequisite for being able to

91
undertake or maintain behaviors that are good for your
health.

2 Enabling factors

Enabling factors are factors that make it possible (or

easier) for individuals or populations to change their
behavior or their environment. Enabling factors include
resources, conditions of living, social support and the
development of certain skills.

Skills

A person or population may need to employ a number of

skills to carry out all the tasks involved in changing their
behavior. For some positive health behaviors it might be
necessary to learn new skills.

For example if a breast feeding mother is not well

trained on positioning and attachment of her baby she
may have difficulty in properly breastfeeding her child.
Similarly, if the mother is not well trained at a later stage
on the preparation of complementary feeding, the child
may not get the nutrition they require.

92
Healthcare resources

A number of healthcare resources may also need to be in

place if an individual or population is to make and
sustain a particular health-related behavior change. The
availability, accessibility and affordability of these
resources may either enable or hinder undertaking a
particular behavior.

For example, in a given health post the lack of

availability of the family planning method of choice for
a mother may discourage her from utilization of the
service in the future.

3. Reinforcing Factors

Reinforcing factors are the positive or negative

influences or feedback from others that encourage or
discourage health-related behavior change. The most
important reinforcing factors are usually related to social
influences from family, peers, teachers or employers.

Social influence

Social influence is the positive or negative influence

from those influential people around us that might
93
encourage or discourage us from performing certain
health-related behaviors.

For example a mother who is planning to start family

planning (FP) She might be influenced by her family:
‘My family members do not all support the idea of using
FP methods, especially my husband and my mother-in-
law. They would really be mad at me if I use FP’. She
may also be aware that her community society or culture
generally may not be supportive: ‘Everyone in our
community is against FP and it is seen as a sin in our
society’.

An individual’s behavior and health-related decision

making — such as choice of diet, condom use, quitting
smoking and drinking, etc. — might very well be
dependent on the social networks and organizations they
relate to. Peer group, family, school and workplace are
all important influences when people make up their
minds about their individual health-related behavior.

Healthy Behaviors for a Healthier Lifestyle

lifestyle and behavior, Daily habits like the foods you

eat, the time you go to sleep and how much activity you
94
get throughout the day have a significant influence on
your health. Each of these behaviors positively or
negatively affects you and dictates the overall state of
your health.

There are several aspects of your lifestyle that might

be influencing your health:

Nutrition habits: The foods we eat have a direct

influence on the health of bodies. Instead of eating to
feel full, focus on eating to increase energy levels,
benefit digestive health and improve overall health.

Hydration habits: To maintain good health, have to

drink plenty of water. A daily minimum of 3 liters (14
cups) of fluid is recommended for men and 2.2 liters (9
cups) for women. Try drinking water instead of sodas or
juices throughout the day.

Physical activity: Staying physically active can help

maintain a healthy weight and body composition,
reducing the risk of weight-related medical conditions. It
can also help maintain the health of muscles, bones and
joints with age.

95
Stress management: Stress triggers a survival response
that can help in the short-term but become damaging if it
persists for a prolonged period. Learning how to control
stress can help retain your mental and physical health.

Sleeping habits: The amount of sleep get every night

dictates energy level, feelings of mental alertness and
ability to maintain a healthy weight level. Try to get
between seven and nine hours of sleep every night.

Daily supplements: Vitamins, nutrients and herbs are

big supporters of health and wellness. Taking
supplements and managing health through detoxification
and other treatment methods can encourage a healthier
lifestyle.

96
 Health literary

Out line:-
Introduction
Definitions
Importance of Health Literacy
Factors Affecting health literacy
High Risk for Low Health Literacy
Effects of Low Health Literacy
Role of Communication in Health Literacy
Role of Health care providers

97
Introduction

Health literacy is increasingly recognized as a

necessary element of all efforts to improve health.
Health literacy is critical for people’s search for and use
of health information; adoption of healthy behaviors;
and decision-making about health issues in the
workplace, community, and society. Furthermore, health
literacy is central to people’s ability to access the public
health and healthcare systems, communicate with health
professionals, and engage in self-care and chronic
disease management.

Definition s:
Functional Literacy:
The basic skills of reading, writing and numeracy taking
context into account
Health literacy

It is the ability to obtain, process, and understand basic

health information and services needed to make
appropriate health decisions and follow instructions for
treatment.

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Importance of Health Literacy:

Health literacy affects our ability to:

Make healthy lifestyle choices (nutrition labels)
Find & understand health & safety information
Locate appropriate health services
Communicate with health providers.
To understand health-related instructions
To follow discharge instructions
Engage in self-care and chronic disease management
Adopt health-promoting behaviors
Factors Affecting health literacy

Health literacy depends on both individual and

systemic Factors
a. Personal Factors:-
Literacy skills
Cognitive skills
Motivation
Physical and emotional health
Experience with health care (people with limited
knowledge about the body and the causes of disease may
not Understand the relationship between lifestyle factors

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(such as diet and exercise) and health outcomes,
recognize when they need to seek care and
** Specific health condition:
Beliefs about health
Socioeconomic status
Social supports
Culture
b. System Factors:-
Provider's communication skills (include literacy
skills (e.g., reading, writing, and numeracy), oral
communication skills, and comprehension).
Complexity of health information
Characteristics of healthcare setting
System demands and expectations upon patients
(individuals need to read, understand, and complete
many kinds of forms in order to receive treatment and
payment reimbursement…etc).
Time pressures upon health care professionals
High Risk for Low Health Literacy

1. Elderly
2. people with chronic diseases
3. People with low income

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 4. People with limited education
Effects of Low Health Literacy

⚫ Poor Health Outcomes

⚫ Under-utilization of preventive services

⚫ Over-utilization of health services

⚫ Unnecessary health care expenditures

⚫ Limited effectiveness of treatment

⚫ Higher patient dissatisfaction

⚫ Higher provider frustration

Role of Communication in Health Literacy

Good communication is crucial for a successful

clinician-patient relationship and effective exchange of
information. Breakdowns in communication can lead to
confusion for patients, poor health outcomes, and even
malpractice lawsuits against clinicians
1. If a provider thinks a patient is having difficulty
understanding written or spoken directions, a good
approach is to say, “A lot of people have trouble

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 reading and remembering these materials. How can I
help you?”
2. Use commonly understood words. For instance, use
“keeps bones strong” instead of “prevents
osteoporosis.”
3. Slow down and take time to listen to a patient’s
concerns. Create an atmosphere of respect and
comfort. Build trust with the patient.
4. Limit information given to patients at each visit.
Remember that less than half of the information
provided to patients during each Visit is retained

Role of health care (SPEAK):-

S: Speech - How will the healthcare provider’s speech

be received by the patient and/or caregiver?
P: Perception - How will the patient and/or caregiver
perceive both the verbal and written content during
the communication with the health care provider?
E: Education - What is the education level of the patient
and/or caregiver?
A: Access – How will the patient and/or caregiver
access the health care system?

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K: Knowledge – How will assessment of health
literacy be carried out, and what tools will be used?

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 Electronic Learning

Out lines

introduction
Definition of E- learning
Types of E- learning
Advantages of E- learning
Disadvantages of E-learning

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Introduction

Electronic learning (e- learning) is a store house of

education, information, communication, and knowledge
and performance management. It is not intended to
replace conventional methods and learning in class
room.Its aim is to create an augmented learning
environment where technology is used to deliver a
combined range of teaching and learning techniques

Definition of e- learning

It is a teaching and learning process by using internet,

media, internet or other computer network in order to
give the material to the students.

or

It is a means of education that incorporates self-

motivation, communication, efficiency and technology.

Types of E- Learning

o Synchronous e- Learning
Learning and teaching takes place in same time. In
synchronous learning, the learners and the teacher are

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 online and interact at the same time from different
locations. They deliver and receive the learning
resources via mobile, video conference, Internet or
chat. In this type of learning the participants can share
their ideas during the session and interact with each
other and they get detailed queries and solutions.
Synchronous e - Learning is gaining popularity
because of improved technology and Internet
bandwidth capabilities. Such as Virtual Classroom,
Audio and Video Conferencing, Chat, Webinars,
Application Sharing and Messaging instantly

2. Asynchronous E-learning

The trainer prepares the courseware material

before the course takes place. Student directed, self-
paced learning. In this type of e- Learning the learner
and the teacher cannot be online at same time.
Asynchronous eLearning may use technologies such as
email, blogs, discussion forums, e- Book’s, CDs, DVDs,
etc. Learners may learn at any time, download
documents, and chat with teachers & also with co-
learners.

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 N. B. In fact, many learners prefer asynchronous
instead of synchronous learning because learners can
take online courses to learn at their preferable time by
not effecting their daily commitments.

Advantages of E- Learning

❖ Promotes active and independent learning.

❖ Able to link the various resources in several
varying formats.
❖ It is a very efficient way of delivering courses
online.
❖ It is a very convenient and flexible, and confidence
❖ Is more cost saving & cost effective than traditional
learning.
❖ Diminishes problems related to in-classroom
teaching of audiences
❖ Access by learners to teachers and resources,
worldwide
❖ Reduce environmental impact.
❖ Reduce overall cost.
❖ Reduce learning time.
Disadvantages of e- learning

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Lack of equipment. Learners need to have access to
a computer as well as the internet.
Lack of knowledge and skills. Learners need to
have computer skills such as word processing,
internet browsers, e- mail.
No self dicipline and no face to face interaction.
Lack of input from trainers.
It also requires just as much time for attending
completing assignments as any traditional
classroom course.
Students may feel isolated from the instructor.
Slow or unreliable internet connections can be
frustrating.
Teachers' lack of knowledge and experience to
manage virtual teacher- student interaction.
Lack of direct and immediate feedback from
teachers.
Bias toward students over non technical students
Asynchronous communication hinders fast
exchange of question

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 blended learning
Outlines :
Introduction
Definition of blended learning
Models of blended learning
Main Characteristics of Blended Learning
The basic requirements for implementing a
successful blended learning
Advantages of Blended Learning

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Introduction

The educational system at present is in a transition stage.

To meet the challenges of expansion and for catering
individuals need it is trying to adopt new technologies
and exploring new paths to reach the goal of quality
educational opportunities for all, at the same time due to
various factors like deficient budgets, lack of facilities,
advantages of face to face interaction, it is not
completely ready to leave the traditional modes of
knowledge transfer.

Definition of blended learning

Is the use of traditional classroom teaching methods

together with the use of online learning for the same
students studying the same content in the same course.

Models of blended learning

MODEL 1: Blended presentation and interaction:

Activity-focused face-to-face sessions blended with

online resources. For example, the flipped curriculum
model combines on short lecture podcasts, online

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resources with face-to-face tutorial/seminars for
interaction and presentation of group work.

MODEL 2: Blended block:

Combination of intensive face-to-face sessions as one

day or half days, weekly online tutorial/seminars for
activities and interaction and online content and
resources.

MODEL 3: Fully online:

Combination of short lecture podcasts with online

resources and learning activities, online tutorials
(synchronous) and interaction via online collaboration,
discussion forums and/or group work

Main Characteristics of Blended Learning

1-Students have the option of the two modes

2-Teachers are well versed with both the modes

3-Students get face to face interaction as well they

interact in virtual space

4-Students get full experience in using new technology

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5-Students get training in different life skills

6-All round development of personality is targeted.

7-Physical development is possible with in school

campus

8-Students get wide exposure and new perspectives of

the course content

9-It has a human touch

10-It provides multicultural and multi dimension

approach to teaching learning process

11-Diverse role of teacher

12-Student constructs knowledge rather than just

consuming it

The basic requirements for implementing a

successful blended learning as the following:

1. Well trained teachers :

2. Teachers with scientific attitude

3. Teachers with wider outlook and positive approach

towards

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 4. Complete facilities like well-furnished computer
lab, internet connection, provision for video
chatting

5. Students have access to internet at their private

computers

6. Flexibility in the system

7. Fully aware and agreed Parents

8. Formative evaluation and continuous internal

assessment

Advantage of Blended Learning:

1-teachers and students get more time in the classroom

for creative and cooperative exercise.

2-Students gain advantage of online learning without

losing social interaction element and human touch of
traditional teaching’

3-It provides more scope for communication.

Communication cycle is completed in blended learning
which is not possible if we follow only traditional
approach

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4-Students become more techno savvy and they gain
enhanced digital fluency

5-Students have more strengthened professionalism as

they develop qualities like self-motivation, self-
responsibility, discipline

6-It updates course content and so gives new life to

established courses.

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 Telehealth
Outlines:

Introduction
Definitions
The Need of telehealth
Forms of telehealth
Benefits of telehealth
Clinical uses of telehealth technologies
Nonclinical uses of telehealth technologies
Telehealth modes
Factors that influencing development of telehealth
services
Methods of telehealth
Challenges
Disadvantage of telehealth
References

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Introduction:

Telehealth is the provision of health care over a

distance. Telehealth is simply using digital information
and communication technologies, such as computers and
mobile devices, to manage your health and well-being.
Telehealth, also called e-health or m-health (mobile
health), includes a variety of health care services.

Definitions
▪ Telehealth is the transmission of health-related
services or information over the
telecommunications technology.

▪ Telemedicine is the exchange of medical information

from one site to another through electronic
communications.

▪ Telenursing: use of telecommunications technology

in delivery, management and coordination of nursing
care to enhance patient care. Or

▪ Telehealth nursing is the delivery, management, and

coordination of care and services provided via

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 telecommunications technology within the domain of
nursing.

The Need of telehealth:

• Administrative meetings
• Aging population
• Clinical education program
• Clinician shortages
• Delayed treatment
• Language barriers
• Misdistribution of providers
• Rural/Urban underserved
• Travel time, cost & hardship

Forms of telehealth delivery:

▪ Simple as two health professional discussing a case
over the phone
▪ Sophisticated as using video conferencing between
providers at facilitates in two countries
▪ Complex as robotic technology

Benefits of telehealth

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1. Improve the way patients and their families access
information
2. Improved health outcomes for patients.
3. Empower consumers and communities by providing
accessible health education and decision-making
options.
4. Improve the way healthcare providers deliver care,
access information, and learn.
5. Enhance recruitment and retention of healthcare
providers in rural or remote areas.
6. Lower healthcare costs, reduce travel, minimize time
off work, and decrease patient waiting time.
7. Decrease self-reported patient anxiety.
8. Eliminate unnecessary repeat diagnostic procedures or
tests.
9. Improve early diagnostic capabilities.
10. Improve administrative and communication
capabilities.
11. Improve emergency triage.
12. Prevent unnecessary delays in receiving treatment.
13. Reduce or eliminate the separation of families
during difficult and emotional time

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14. Allow patients to spend less time in waiting rooms

Clinical uses of telehealth technologies:

1. Transmission of medical images for diagnosis (often
referred to as store and forward telehealth)
2. Groups or individuals exchanging health services or
education live via videoconference (real-time
telehealth)
3. Transmission of medical data for diagnosis or disease
management (sometimes referred to as remote
monitoring)
4. Advice on prevention of diseases and promotion of
good health by patient monitoring and follow up.
5. Health advice by telephone in emergent cases
Nonclinical uses of telehealth technologies
1. Distance education including continuing medical
education, grand rounds, and patient education
2. Administrative uses including meetings among
telehealth networks, supervision, and presentations
3. Research on telehealth
4. Online information and health data management
5. Healthcare system integration

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6. Asset identification, listing, and patient to asset
matching, and movement
7. Overall healthcare system management
8. Patient movement and remote admission
Telehealth modes:
1- Store-and-forward telehealth
In store-and-forward telehealth, digital images, video,
audio, observations of daily living and clinical data are
captured and "stored" on the client computer or mobile
device; then at a convenient time they are transmitted
securely ("forwarded") to a clinic at another location
where they are studied by relevant specialists. The
opinion of the specialist is then transmitted back. Based
on the requirements of the participating healthcare
entities, this round trip could take between 1 minute to
48 hours. In the simplest form of telehealth application,
basic vital signs like blood pressure, weight, and blood
sugar values are monitored and trended for long term
chronic care.

2- Real-time telehealth

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In real-time telehealth, a telecommunications link
allows instantaneous interaction. Videoconferencing
equipment is one of the most common forms of real-
time (or "synchronous") telemedicine. Peripheral
devices can also be attached to computers or the video-
conferencing equipment which can aid in an interactive
examination. With the availability of better and cheaper
communication channels, direct two-way audio and
video streaming between centers through computers is
leading to lower costs.
Examples of real-time clinical telehealth include:
• Tele-audiology
• Telecardiology
• Teledentistry
• Teleneurology
• Telenursing
• Telerehabilitation
3- Remote patient monitoring
In remote monitoring, the patient has a central
system that feeds information from sensors and
monitoring equipment, e.g. Blood pressure monitors and
blood glucose meters, to an external monitoring center.

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This could be done in either real time or the data could
be stored and then forwarded.
Examples of remote monitoring include:
• Cardiac and multi parameters monitoring of remote
ICU
• Home telehealth
• Disease management
4- Remote Training
Telehealth also provides opportunities for health care
professionals in remote locations to receive training. In
the United States, the Extension for Community
Healthcare Outcomes or ECHO project uses a telehealth
platform to help urban medical center specialists train
primary care doctors in rural settings. The training
allows these general practitioners to provide specialty
care, especially chronic condition services, that would
otherwise be unavailable to patients in these areas.
Examples of remote monitoring include:
• Home-based nocturnal dialysis.
• Cardiac and multi-parameter monitoring of remote
ICUS

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• Disease management including COPD, Chronic Heart
Failure, Diabetes, Coagulation, Arthritis, Depression,
Obesity
Factors that influencing development of telehealth
services
1. Aging population: the needs of aging health care
consumers have initiated efforts to develop and adopt
better telehealth system outside institutional walls,
system that would be better geared for home- based
application
2. Cost containment: telehealth system are facilitating
redistribution of health care services, reducing
duplication, reducing number of drug interaction and
reducing patient and professional travel
3. Access: demand is increasing for equitable access to
health care services for inhabitants of isolated
geographic areas
4. Technology: ever more powerful technology and
communication band width are becoming available at
decreasing cost
5. Demand: the increasing demand for wellness and
health information

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Methods of telehealth:
The use of advanced telecommunication technology
to exchange information and provide health care
services across geographic, time, social barriers:
▪ Telephone, radio, other voice modalities
▪ Picture phone, teleconferencing
▪ Fax, email
▪ Computers for data/ imaging
▪ Interactive video
Challenges of telehealth:
• Break down in the relationship between health
professional and patient.
• Break down in the relationship between health
professionals.
• Issues concerning the quality of health information.
• Organizational difficulties.
Disadvantages of Telehealth
• Regulatory barriers
State laws are either unclear or may forbid practice
across state lines.
• Lack of repayment for consultative services

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Most third party payers do not provide reimbursement
unless the client is seen in person.
• Fear of healthcare system changes
Personnel may fear job loss as more clients can be
treated at home and hospital units close
• Costs for equipment, network services, and
training time
Equipment capable of transmitting and receiving
diagnostic-grade images is expensive.
• Lack of acceptance by healthcare professionals
This may stem from liability concerns and discomfort
over not seeing a client face-to-face.
• Lack of acceptance by users
This may stem from discomfort with technology, the
relationship with the provider, and concerns over
security of information and confidentially.

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