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Abbie Sudduth

CHES Exam Study Guide Area of Responsibility I: Assess Individual and Community Needs for Health Education The Role●

The primary purpose of the needs assessment is to gather information to determine what health education activities are appropriate in a given setting.

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Community Setting School (K-12) Setting Health Care Setting Business/Industry Setting College/University Setting University Health Services Setting

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Needs Assessment: is the systematic identification of needs within a population and determination of the degree to which those needs are being met. Primary Data: are date gathered by the hearth education directly from or about the individual or population of interest. These data answer questions related to the specific needs assessment. Primary data are often collected by means of surveys, interviews, focus groups and direct observations. Secondary data (existing date): are data that have already been gathered by others that may or may not be directly from the individual or population being assessed. Examples include existing research published in peer-reviewed journals and/or datasets, such as the US Census, Vital Records and Disease Registries.

Competency A: Access Existing Health-Related Data ● ● ● ●

Identify diverse health-related databases Use computerized sources of health-related information Determine the compatibility of data from the different data sources Select valid sources of information about health needs and interests

Competency B: Collect Health Related Data ● ● ● ●

Use appropriate data-gathering instruments Apply survey techniques to acquire health data Conduct health-related needs assessments Implement appropriate measures to assess capacity for improving health status

Competency C: Distinguish Between Behaviors that Foster or Hinder Well-Being ●

Identify diverse factors that influence health behaviors

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Identify behaviors that tend to promote or compromise health

Competency D: Determine Factors that Influence Learning* Competency E: Identify Factors that Foster or Hinder the Process of Health Education ● ●

Determine the extent of available health education services Identify gaps and overlaps in the provision of collaborative health services

Competency F: Infer Needs for Health Education from Obtained Data ●

Analyze needs assessment data

*This competency is not addressed because the sub-competencies are related to an advanced level of practice.

Area of Responsibility II: Plan Health Education Strategies, Interventions, and Programs The RoleProgram planning begins with the assessment of existing health needs, problems, and concerns.

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Programs: are defined as a set of planned activities over time designed to achieve specific objectives. Program Planning: is the process of identifying needs, establishing priorities, and diagnosing causes of problems, assessing and allocating resources, and determining barriers to achieving goals. A mission statement: is a statement of the distinctive purpose of and unique reason for the existence of a program. A mission statement can be a one-sentence statement or a short narrative that broadly defines the program’s purpose. Mission statements are enduring over time and identify the scope or focus of the organization or program. Goals: are general, long term statements of desired program outcomes and provide the directions upon which all objectives are based. Objectives: are statements that describe, in measureable terms, the changes in behavior, attitude, knowledge, skills, or health status that will occur in the intervention group as a result of the program. Objectives are small, specific steps that enable the goal to be met. Stakeholders: are individuals or agencies that have a vested interest in the health education program. A community-based organization (CBO): is a public or private, nonprofit organization of demonstrated effectiveness that is representative of a community or significant segments of a community and provides educational or related services to individuals in the community. Social Marketing: is the use of marketing principles to promote a product, idea, or attitude among members of a population.

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Health communication: is the art and technique of informing, influencing, and motivating individual, institutional, and public audiences about important health issues.

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Competency A: Involve People and Organization in Program Planning ● ● ● ●

Identify populations for health education programs Elicit input from those who will affect or be affected by the program Obtain commitments from individuals who will be involved in the program Develop plans for promoting collaborative efforts among health agencies and organizations with mutual interests o Steps to an effective coalition: 1. Analyze the issue of problem on which the coalition will focus 2. Create awareness of the issue 3. Conduction initial coalition planning and recruitment 4. Develop resources and funding for the coalition 5. Create coalition infrastructure 6. Elect coalition leadership 7. Create an action plan

Competency B: Incorporate Data Analysis and Principles of Community Organization ● ● ● ●

Use research results when planning programs Apply principles of community organization when planning programs Suggest approaches for integrating health education with existing health programs Communicate need for the program to those who will be involved o Primary Communication Channels: ● Intrapersonal ● Interpersonal ● Organizational and Community ● Mass Media

Competency C: Formulate Appropriate and Measurable Program Objectives ●

Design developmentally appropriate intervention o Types of Objectives Objective

Result

Evaluation

Program Objective

Changes in morbidity, mortality, quality of life

What is the outcome? Is there a change in health status and is it attributed to the program?

Environmental Objective

Changes in environment

How has the environment changed to improve behavior and health?

Behavioral Objective

Changes in behavior, behavioral adaptation

What is the impact? Is there adaptation of a new healthier behavior and can it be attributed to the program?

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Learning Objective

Changes in knowledge, attitude, practices, etc.

Is there requisite change in knowledge, attitudes, habits and skills needed for behavior change?

Admin (process) Objective

Adherence to time line tasks, completion of activities, efficient use of resources

Is the program working? Are people attending? Are the methods appropriate?

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Components of program planning include: ● Understanding and engaging the priority population ● Conducting goals and objectives ● Creating an intervention ● Implementing the intervention ● Conducting program evaluation Planning Models ● Preceded-Proceed Model PRECEDE 1. Social Assessment: define the quality life of the priority population. 2. Epidemiological Assessment: identify the health problems of the priority population. 3. Behavioral and Environmental Assessment: determine and prioritize behavior and environmental risk factors associated with the health problem. 4. Educational and Ecological Assessment: determine predisposing, enabling, and reinforcing factors. PROCEED

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5. Administrative and Policy Assessment: determine the resources available for the program. 6. Implementation: select strategies and activities: begin program. 7. Process Evaluation: document program feasibility. 8. Impact Evaluation: assess the immediate effect of an intervention. 9. Outcome Evaluation: determines whether long-term program goals were met. MATCH 1. Goals selection 2. Intervention planning 3. Program development 4. Implementation preparation 5. Evaluation Social Marketing for Community Level Planning

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Health Communication for Community Level Planning CDCynergy 1. Define and describe the problem 2. Analyze the problem 3. Identify and profile the audience 4. Develop communication strategies 5. Develop evaluation plan 6. Launch the plan and obtain feedback

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Competency D: Develop a Logical Scope and Sequence Plan for Health Education Practice ●

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Determine the range of health information necessary for a given program of instruction o Learning Principles ● Use several senses ● Actively involve participants ● Provide an appropriate learning environment ● Assess learner readiness ● Establish the relevance of the information ● Use repetition ● Strive for a pleasant learning experience ● Start with the known and move toward the unknown ● Generalize the information ● Appropriately pace delivery of the information Select references relevant to health education issues or programs o Health Information Resources: ● US Census Reports ● Morbidity and Mortality Weekly Report ● Vital Statistic Reports ● Health Planning Agency Reports ● Trend data overtime from the National Center for Health Statistics ● World Health Reports

Competency E: Design Strategies, Interventions, and Programs Consistent with Specified Objectives* *This competency is not addressed because the sub-competencies are related to an advanced level of practice.

Competency F: Select Appropriate Strategies to Meet Objectives The most appropriate interventions should be based on theory, available resources, and reasonable fit.

-Educational strategies – associated with coursework -Health engineering strategies – examples: airbags, safety belts -Community Mobilization strategies – examples: coalitions -Health Communication strategies – all communication channels -Health Policy/Enforcement strategies – based on “common good” -Health Related Community Service strategies – examples: screenings ● ●

Analyze technologies, methods, and media for their acceptability to diverse groups Match health education services to proposed program activities

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Competency G: Assess Factors that Affect Implementation ● Determine the availability of information and resources needed to implement health education programs for a given audience ● Identify barriers to implementation of health education programs

Area of Responsibility III: Implement Health Education Strategies, Interventions, and Programs The RoleTo infer objectives suitable to the program, select media and methods appropriate to the intended audience, conduct programs as planned, and make revisions to programs and objectives consistent with results from having monitored their program in action.

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Implementation: the process of putting a project, service, or program into effect Learning Activities: the means used to carry out or implement the program. These are the instructional sessions that will address the learning objectives. Tailored Message: any combination of information and behavior change strategies intended to reach one specific person or group, based on characteristics unique to that person, related to the outcome of interest and derived from an individual assessment.

Competency A: Initiate a Plan of Action ● Use community organization principles to facilitate change conducive to health ● ● ● ● ● ● ● ● ● ●

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Recognize the issue Gain entry into the community Organize the people Assess the community Determine the priorities and set goals Arrive at a solution and select intervention strategies Implement the plan Evaluate the outcomes of the action plan Maintain the outcomes in the community Loop back (to 4-9)

Pretest learners to determine baseline data relative to proposed program objectives Deliver education programs to diverse populations ● Cultural Competency required ● Cultural Sensitivity required Facilitate Groups

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Competency B: Demonstrate a Variety of Skills in Delivering Strategies, Interventions, and Programs ● ●

Use Instructional technology effectively Apply implementation strategies Implementation process in health education: Phase 1: Gain acceptance for the program Phase 2: Specify tasks and estimate resources Phase 3: Establish a system for program management Phase 4: Put the plans into action -Piloting, pilot testing or field testing -Phasing-in -Total Implementation Phase 5: Ending or sustaining a program

Competency C: Use a Variety of Methods to Implement Strategies, Interventions, and Programs ● ●

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Use the Code of Ethics in professional practice Apply theoretical and conceptual models from health education and related disciplines to improve program delivery o Social Cognitive Theory (self-efficacy) o Transtheoretical Model (Stages of Change Model) ▪ Precontemplation ▪ Contemplation ▪ Preparation ▪ Action ▪ Maintenance ▪ Termination o Health Belief Model (perceived severity & susceptibility) o Theory of Planned Behavior (motivation to comply) o Diffusions of Innovations Theory ▪ Innovators ▪ Early Adopters ▪ Early Majority ▪ Late Majority ▪ Laggards Demonstrate skills needed to develop capacity for improving health status Incorporate demographically and culturally sensitive techniques when promoting programs Implement intervention strategies to facilitate health-related change o Issues related to implementation

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Legal Issues: Informed Consent & Negligence from omission or commission Safety Issues Ethical Issues

Competency D: Conduct Training Programs* *This competency is not addressed because the sub-competencies are related to an advanced level of practice.

Area of Responsibility IV: Conduct Evaluation and Research Related to Health Education The RoleConduct a thorough review of the literature and apply research findings from basic and evaluative research. Conduct evaluations of projects and programs. Write applications for funding, including research proposals. Poses the ability to evaluate a program’s effectiveness is essential to maintaining its funding in an increasingly competitive work environment. The ability to aggregate data from one of more programs for the purpose of establishing baselines and making comparison is also important.

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Evaluation: assess a process or program to provide evidence and feedback to the program Research: an organized process founded upon the scientific method for investigating problems. It involves systematic progression through a series of necessary steps. Reliability refers to the consistence, dependability, and stability of the measurement process. Validity: the degree to which a test or assessment measures what it is intended to measure. Using an acceptable (valid) instrument increase the chance of measuring what was intended. Variables: operational forms of a construct. They designate how the construct will be measured in designated scenarios.

Competency A: Develop Plans for Evaluation and Research ● ●

Synthesize information presented in the literature Evaluate research designs, methods, and findings presented in the literature Questions for evaluation literature: 1. Was the purpose of the study stated? 2. Was the research question or hypothesis stated? 3. Were the subjects in the study described? Did the literature describe subject recruitment? 4. Was the design and location of the study described? 5. Were the data collection instruments described? 6. Did the presented results reflect the research question or hypothesis? 7. Were the conclusions reflective of the research design and data analysis? 8. Were the implications meaningful to the priority population?

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Competency B: Review Research and Evaluation Procedures ● ●

Evaluation data-gathering instruments and processes Develop methods to evaluate factors that influence shifts in health status o Formative Evaluation (process evaluation): ongoing process of evaluation while the program is being developed and implemented. o Summative Evaluation: associated with quantitative processes. It is also commonly associated with the impact and outcome evaluation. o Four common evaluation Models: ▪ Decision-Making Model ▪ System Analysis ▪ Accreditation ▪ Goal Free

Competency C: Design Data Collection Instruments ●

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Develop valid and reliable evaluation instruments o Content or Face Validity: considers the instruments items of measurement for relevant areas of interest. o Criterion Validity: refers to one measure’s correlations to another measure of a particular situation o Construct Validity: ensures that the concepts of an instrument relates to the concepts of a particular theory o Reliability: assess whether the instrument is measuring concepts consistently Develop appropriate data-gathering instruments o Develop instrument specifications o Develop instructions for implementing the instrument and examples of how to complete items o Establish item scoring procedures o Conduct an item analysis and reliability and validity tests

Competency D: Carry Out Evaluation and Research Plans ●

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Use appropriate research methods and designs in health education practice ▪ Qualitative Research ▪ Quantitative Research Use data collection methods appropriate for measuring stated objectives Implement appropriate qualitative and quantitative evaluation techniques ▪ IRB (institutional review board) Implement methods to evaluate factors that influence shifts in health status o Three Primary Tasks: measurement, use of a design, and analysis of the data o Internal Validity: refers to identifying the effects as being attributed to the program and not to other factors related to the evaluation deign

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External Validity: allows health educations to apply the concepts of generalizability

Competency E: Interpret Results from Evaluation and Research ● ●

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Analyze evaluation data Analyze research data o Descriptive Analysis: aims to describe the group being studied o Inferential Analysis: gains knowledge about the sample that be generalized to a similar population Compare evaluation results to other findings Report effectiveness of programs in achieving proposed objectives o Evaluations or Research Report: typical form of communication used to report the outcome of the plan set forth by the evaluation or research planners. It is important to provide user-friendly information to the stakeholders involved. ▪ Introduction ▪ Literature Review ▪ Methodology ▪ Results ▪ Conclusions, Recommendations, or a Summary

Competency F: Infer Implications from Findings for Future Health-Related Activities* *This competency is not addressed because the sub-competencies are related to an advanced level of practice.

Area of Responsibility V: Administer Health Education Strategies, Interventions, and Programs The RoleHealth educators often become program managers or supervisors of other health educators or teams of allied health professionals. This role requires effective communication skills, organizational knowledge, and objectivity.

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Coalitions: groups of individuals in an alliance who represent various organizations from within the community who agree to work together toward a common goal. Culture: a pattern of assumptions developed ...