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The Role of Health Education

Great threads of discussion on the HEDIR regarding the role of Health Education.  Read through and feel free to comment.

“Watson, Tyler” Feb 17 01:02PM -0700 ^
Hello my fellow compassionate service workers…

I have been thinking seriously the last few weeks about something and I would like your input.

Healthcare costs are continuing to climb and even with significant reforms I am not confident that the slope of the curve will flatten anytime soon. With the economic pressures being applied to the health system, many of the only solutions seem to be focused on capping costs (i.e. reducing benefits, capitation, more efficient service, expanded use of para-professionals in the clinical setting).

So I wonder… Is our profession poised for the future, or are we chasing the problems of yesterday?

We have a set of skills as outlined in the 7 core competencies and most of us feel like we are well positioned as competent content experts in prevention…
BUT-is that what the FUTURE health educator (or whatever the name may be) will need in their tool belt to address the needs of those seeking health care and those who are responsible for providing it?

I wonder, do we need to train our students in clinical assessment and standard of care procedures for some classifications of patients?
Do we need to have good background in both behavior theory AND hands on clinical management?

Would we be abandoning our professional staples and venturing into other scopes of practice? If so— Is that a good or bad thing?

I know I wish that I was able to bring more to the table in clinical assessment and management… and not hang on the fringes of the table hoping for scraps (what is not being provided in the doctors office)…

Love to hear what you have to say, and maybe even come up with some ideas to conduct a solid needs analysis that might lead us to fill a potential future gap in the health care system.

Tyler Watson, MPH, CHES
Health Science
Brigham Young University-Idaho
Rexburg, ID 83440

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Ranjita Misra Feb 17 08:31PM
Dear Tyler,

Good point. I want to direct your attention to a special issue of our Journal , the Health Education Monograph Series which will focus on “Emerging Career Paths for Health Educators”. Dr. Delores James from University of Florida is the Guest Editor for this special issue; Dr. Mohammad Torabi is the editor of the Monograph Series.

I have often brooded over the same points and have addressed it in a chapter on this upcoming special issue entitled “Health Educators of the21st century: A Member of the Transdiciplinary Team.” As a health disparities researcher, I often work with a multidisciplinary team. As members of a transdiciplinary team, health educators are well poised to deliver evidence-based practice as well as implementation of research translation in clinic, school and community settings. Most of our efforts on primary and secondary prevention fit into the T2 category of the translational research specified by the National Institute of Health and Institute of Medicine.

However, are our skills and competencies adequate and confer a competitive advantage for us in the transdiciplinary team? Is the CHES competencies and skills unique to our profession? In other words, is a health educator uniquely prepared than other health professionals (e.g., nursing, social work, psychology, health communication, criminal justice) that work in prevention intervention areas of public health? I have presented my stand on this in the manuscript.

Best regards,

Ranjita Misra

Ranjita Misra, PhD, CHES
Professor & Research Director
Center for the Study of Health Disparities (CSHD)
Department of Health and Kinesiology
Member, Intercollegiate Faculty of Nutrition
158V Read Building
Texas A&M University, College Station, TX 77843

President, Eta Sigma Gamma, National Health Science Honor Society
Past President, South Asian Public Health Association

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Kristina Davis Feb 17 02:33PM -0600 ^
I think looking forward programs should train students in project management
capacities and help health educators learn to build interprofessional
networks with clinicians and others. The health educator of the future will
not be a stand alone entity (this will not survive especially with the
increased specialization of services) but one that can enmesh his or herself
to fill in the holes of other services providers. For example, partnering
with fire fighters to make sure that the preventive services they provide
(child safety, smoke detectors, gun safety, etc.) are delivered in plain
language and culturally appropriate manners or working with professional
organizations (AHA, AMA, APIC, ACPM etc.) on their programs delivered to
ensure they are delivered in a way to maximize education. Those are my
thoughts.
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Stephen Brown Feb 17 03:30PM -0600 ^
Tyler, interesting question. I was recently talking to a group of graduate
students about selecting research topics. We reviewed a couple of related
documents: The CDC report subtitled, *A Guide to Public Health Research
Needs* **(
http://www.cdc.gov/od/science/PHResearch/cdcra/AdvancingTheNationsHealth.pdf),
and the Institute of Medicine report subtitled, *Educating Public Health
Professionals for the 21st Century* (
http://www.nap.edu/catalog.php?record_id=10542#toc). Both have similar
priorities and both put emphasis on human genomics, informatics, global
health, participatory research, social determinants of health, mass health
communication, health policy/law, and cultural relevance in a changing
society. Limited space was devoted to discussion of what we might consider
conventional health education practice. I believe the capability to
integrate into a clinical setting is implied, as is the need for larger
public health approaches. Although the core competencies obviously can
apply to these types of priorities, I also wonder whether our students are
getting enough specific training in these areas. And, even if we wanted to
give this training, could we fit it into the current number of credit
hours. I also personally wonder whether I have sufficient expertise to give
this training.

Following this discussion, one of the students in class chose to do her
paper on the role of health educators in the Medical Home Model, a clinical
care model favored by many health care reform advocates. She interviewed
physicians, nurses, and administrators at a very prominent Medical Home.
Two overarching findings were most interesting to me: 1) as a health
educator, she could identify many opportunities for health educators to play
an integral role in this model, and 2) the parties interviewed
underestimated both the capabilities of and the need for a trained health
educator.

Stephen
*
Stephen L Brown PhD*
Associate Professor–Public Health Education
Graduate Director–Department of Health Education and Recreation
Mailcode 4632
Southern Illinois University
Carbondale IL, 62901-4632
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Mark Fulop Feb 17 02:18PM -0800 ^
Tyler,

The list has been quiet. Thanks for stirring it up. When have health
educators ever had a role in the medical industrial complex? I went
into health education, in part to become an antagonist to the medical
industry. When I got training it was from the perspective that health
educators have always been those seeking to overthrow the profit
driven disease model of health care and seeking to prevent disease
through education, advocacy and organizing. My advice to those
wanting clinical skills that they become the other kind of doctor : )

Having said that, and knowing that there are many health educators
hoping to embed themselves in the lucrative medical industrial
complex, I think the discipline could learn a lot from the library
sub-discipline of medial librarianship (note the Medical Library
Association has a peer reviewed journal that
http://www.ncbi.nlm.nih.gov/pmc/journals/93/). These librarians have
found a way to make themselves as integral service provider in the
clinical environment. I would point out a great collection of
resources to sup your thinking in this direction.
http://www.mlanet.org/resources/vital/

m


Mark Fulop, MA, MPH

Facilitation & Process, LLC
“Productive meetings. Smart strategies. Lasting Impact
PO Box 18144
Portland, OR 97218-0144

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“Froehle, Mary” Feb 17 05:37PM -0600 ^
I would disagree that health educators working in the medical field have “imbedded” themselves in the “medical industrial complex.” I am proud that the work health educators do can prevent or improve chronic health conditions when medicine can only do so much. Unfortunately, the population I work with, we all may work with, may already have elevated blood pressure, be overweight, not currently participate in regular physical activity, or not regularly test for things like cervical cancer, etc. Health education involves not only primary prevention approaches, but in many cases, secondary and sometimes tertiary strategies. The Medical Home Model, for example, was referred to in an earlier email by Dr. Stephen Brown. Health educators can, do, and will play a crucial role in the coordination of care, patient education, and measurement of outcomes for this Model and the Chronic Care Model. When health educators work in a healthcare setting, positive outcomes may include a reduction in the number of medications taken, less emergency room visits, improvement in chronic conditions, and the prevention of life-threatening diseases (such as cancers). As people live longer and develop chronic conditions, the need for health educators in the medical/healthcare setting will grow. Not all health educators can teach in an academic setting, work at the state or local health department, or run a for-profit consulting business. Some, like me, work with patients in a clinical setting (in a not-so lucrative, yet fiscally responsible, publically- owned safety net hospital) where the right combination of clinical intervention and health education will optimistically lead to positive outcomes.

Mary Froehle, BS, CHES
Care Coordinator – Medical Home
Broadlawns Medical Center
1801 Hickman Road
Des Moines, IA 50314

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“Watson, Tyler” Feb 17 04:46PM -0700 ^
Mary’s experience and position is what I refer to when I say we need to position for the future. HMO’s will be back (albeit with a new name– medical home etc) and health educators and their preparation programs need to ensure that we are ready for the demands that will be placed on us to help contain costs, prevent and manage disease and “rethink” the classic medical model.

Tyler Watson

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Mark Fulop Feb 17 03:49PM -0800 ^
Mary,

Please don’t get me wrong, inherent in Tyler’s opening post was
concern about health care cost containment. True costs are contained
before people walk through the doors of the Medical Industrial
Complex. As I just said in an email to an individual on the list
“Health education embedded in the hospital is pulling bodies out of
the water as they float by. Community health education is about going
upstream and figuring out why people are falling into the river in the
first place and preventing it at the source rather than the end stage.
Isn’t that where true health care cost containment is to be found?”
So my opening was more of a philosophical statement about health
education as primary rather than tertiary care.

Also don’t ignore the other half of my post that pointed to the MLA
model of taking what, on the surface, seems tangential to health care
(library science) and making a direct valuae add to the medical
system. I suggest for those in tertiary care that such is the
approach that health Educators need to be stronger in.

m


Mark Fulop, MA, MPH

Facilitation & Process, LLC
“Productive meetings. Smart strategies. Lasting Impact
PO Box 18144
Portland, OR 97218-0144

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Ranjita Misra Feb 17 09:31PM ^
FYI

Ranjita Misra, PhD, CHES
Professor & Research Director
Center for the Study of Health Disparities (CSHD)
Department of Health and Kinesiology
Member, Intercollegiate Faculty of Nutrition
158V Read Building
Texas A&M University, College Station, TX 77843

FOR IMMEDIATE RELEASE

THURSDAY, FEB. 17, 2011

** CENSUS BUREAU MEDIA ADVISORY **

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