This document provides information on health promotion and education programs. It defines key terms like health education and health promotion. It discusses various models and theories of health behavior change. It also outlines principles, methods, and important considerations for effective health education programming, including targeting different audiences and settings, using various educational approaches and tools, planning evaluation, and addressing barriers. The overall purpose is to educate about concepts and best practices in health promotion.

1. ESIC Medical College, Hyderabad, India
Evaluation of
Health Promotion
& Education
Program

2. Learning Outcomes
1. Differentiate health promotion from health
protection or illness prevention.
2. Identify various types and sites of health
promotion programs.
3. Discuss the Health education.
4. Explain the stages of health behavior change.
5. Discuss planning, implementing, and
evaluating as they relate to health promotion.

3. DEFINITIONS
The National Conference on Preventive
Medicine [USA]:
Health education is a process
• which informs, motivate and helps people to
adopt and maintain healthy practices and life
styles;
• advocates environmental changes as needed to
facilitate this goal and
• conducts professional training and research to
the same end.

4. WHO Definition
Health education, like general education,
is concerned with changes in knowledge,
feelings and behaviour of people.
In its most usual forms, it concentrates on
developing such health practices as are
believed to bring about the best possible
state of well being.

5. Defining Health Promotion
• Three levels of prevention
– Primary focuses on health promotion,
protection against specific health problems
– Secondary focuses on early identification of
health problems, prompt intervention to
alleviate health problems
– Tertiary focuses on restoration and
rehabilitation with the goal of returning the
individual to an optimal level of functioning

6. AIMS OF HEALTH EDUCATION
• To inform the general public of the principles of
physical and mental hygiene and methods of
preventing avoidable diseases.
• To create an informed body of opinion and
knowledge E.g. social workers, teachers
• To give the public accurate information of
medical discoveries.
• To facilitate the acceptance and proper usage
of medical measures.

7. METHODS OF APPROACHES IN
HEALTH EDUCATION
1. Legal or Regulatory Approach
2. Administrative or Service Approach
3. Educational Approach

8. Legal or Regulatory Approach
• Makes use of the law to protect the health
of the public.
• Eg : Epidemic Diseases Act , Pollution Act
• Limitations :
1. applicable only at certain times or
limited situations.
2. they may not alter the behaviour of the
individual.

9. Administrative or Service Approach
• Intends to provide all the health facilities
needed by the people
• ‘felt needs of people’

10. Educational Approach
• Most effective
• Components :
1. motivation
2. communication
3. decision making
• Results slow , but permanent and enduring.
• Sufficient time for an individual to bring about changes
• Learning new facts as well as unlearning wrong
information as well.

11. CONTENTS OF HEALTH EDUCATION
1. Human Biology
2. Nutrition
3. Hygiene
4. Family Health Care
5. Control of Communicable and Non-
Communicable Diseases
6. Mental health
7. Prevention of Accidents
8. Use of Health Services

12. Figure 16-4 The Health Promotion Model (Revised).
From Health Promotion in Nursing Practice, 6th ed. (p. 45), by N. J. Pender, C. L. Murdaugh, and M. A. Parsons, 2011,
Upper Saddle River, NJ: Prentice Hall. Reprinted with permission.

13. Figure 16-5 The stages of change are rarely linear. It is
more common for people to recycle several times through
the stages. The person who takes action and has a
relapse (recycles through some or all of the stages again)
is more apt to be successful the next time than the
individual who never takes action.
Diagram based on content from Changing for Good, by J.
O. Prochaska, J. C. Norcross, and C. C. DiClemente,
1994. Copyright by J. O. Prochaska, J. C. Norcross, and
C. C. DiClemente. Reprinted by permission of
HarperCollins Publishers Inc.; and “The Transtheoretical
Model and Stages of Change” by J. O. Prochaska, C. A.
Redding, and K. E. Evers, in Health Behaviors and Health
Education: Theory, Research, and Practice, 3rd ed., 2009,
by K. Glanz, B. K. Rimer, and F. M. Lewis (Eds.).
Copyright © 2009 by Jossey-Bass. Reproduced with
permission from John Wiley & Sons, Inc.

14. STAGES IN ADOPTION OF NEW
IDEAS AND PRACTICES
STAGE OF UNAWARENESS
Not aware of new idea or practice
STAGE OF AWARENESS
Gets some information but not
know much
STAGE OF INTEREST
Shows interest to know more
Listen, read
STAGE OF EVALUATION
Find out advantages &
disadvantages
STAGE OF TRIAL
Puts it into practice
STAGE OF ADOPTION
Accepts new idea as beneficial
to him & adopts it

15. PRINCIPLES OF HEALTH
EDUCATION
• INTEREST
• PARTICIPATION
• COMPREHENSION
• MOTIVATION
• REINFORCEMENT
• KNOWN TO UNKNOWN
• LEARNING BY DOING
• SOIL, SEED & SOWER
• COMMUNITY LEADERS
• GOOD HEALTH RELATIONS

16. Interest
• Topic of interest
• Identify the ”felt needs” of the people
• Then prepare a programme

17. Participation
• Educator should encourage people to
participate in health education
programmes
• Group discussions, panel discussions, etc
provide oppurtunities for people’s
participation
• Leads to acceptance

18. Known to Unknown
• Start with what the people already know
and then give the new knowledge
• Existing knowledge as people as the basic
step

19. Comprehension
• Determine the level of literacy and
understanding of audience.
• Language of communication,
understandable to audience
• Usage of technical or medical terms
should be avoided.

20. Reinforcement
• Also called as “booster dose”
• Refers to repetition needed
• When not possible for people to learn new
things in short time

21. Motivation
• Defined as “the fundamental desire for learning
in an individual”
• 2 types :
primary motive  inborn desires
food, clothing, housing
secondary motive  outside forces
gifts, a word of praise,
love, rewards

22. Learning by Doing
• Learning process accompanied by doing
the new things.
• Based on famous Chinese proverb “if I
hear, I forget ; if I see, I remember ; if I do,
I know.

23. Soil, Seed & Sower
• Soil  people to whom education is given
• Seeds  Health facts to be given
• Sower media to transmit the facts
• All components are interdependent and
result in dynamic interaction.

24. Good Human Relations
• health educator should have good
personal qualities
• Should be able to maintain friendly
relations with people
• Should have a kind nad sympathetic
attitude

25. Community leaders
• Leaders can be used to reach people of
the community and to convince them
about the need for health education.

26. BARRIERS IN COMMUNICATION
• Psychological barriers
 emotional disturbances
 depression
 neurosis
• Physiological barriers
 difficulties in self-expression
 difficulties in hearing or seeing
 difficulties in understanding

27. HINDRANCES…
• Environmental barriers
 excessive noise
 difficulties in vision
 congested areas
• Cultural barriers
 persistent patterns of behaviour, habits,
beliefs, customs, attitudes, religion, etc

28. EDUCATIONAL AIDS USED IN
HEALTH EDUCATION
1. Audio aids
2. Visual aids
3. Combination of Audio-Visual aids

29. Audio Aids
• Based on principles of sound, electricity and
magnetism
 megaphones
 public addressing systems or
microphones
 Gramophone records
 Tape recorders
 Radios
 Sound amplifiers

30. Visual Aids
• Based on principles of projection
Projected aids – needs projection from a
source on to a screen
 films or cinemas
 film strips
 slides
 overhead projectors
 transparencies
 video cassettes
 silent films

31. Non-projected Aids – do not require projection
 blackboard
 pictures
 cartoons
 photographs
 posters
 flashcards
 charts
 brochures
 models
Other aids – traditional media which makes use of light and sound
stimuli
 Folk dances and Folk songs
 Puppet shows
 Dramas

32. Combination of Audio-Visual Aids
• Modern media available
• Sound & sight combined together to create
a better presentation
 televisions
 tape and slide combinations
 Video Cassette Players and Recorders
 Motivation pictures or Cinemas
 Multimedia Computers

33. HEALTH EDUCATION FOR THE
GENERAL PUBLIC
• Mass communication literally means
communication that is given to a community
where the people gathered together does not
belong to one particular group.
• Advantages
 large no. of people can be reached
 people of all socio-economic status
irrespective of their caste, creed and religion
• Medias
televisions, radios, posters, news papers, etc

34. ESSENTIALS OF HEALTH
EDUCATON TO THE PUBLIC
1. Accuracy and Truth
2. Presentation must be simple
3. Health education should be factual
4. Principles of health should be taught

35. Sites for Health Promotion Activities
• Various settings for programs:
– In home
– Community setting
– Schools
– Hospitals
– Worksites

36. 44
• Monitoring and evaluation are essential management
tools which help to ensure that health activities are
implemented as planned and to assess whether desired
results are being achieved.
• Monitoring:
1. To provide concurrent feedback on the progress of
activities
2.To identify the problems in their implementation
3.To take corrective action
Evaluation:
To assess whether the desired results of a programme
have been achieved if not how it should be redesigned

37. 45
MONITORING
A process of measuring, recording,
collecting and analyzing data on
actual implementation of the
programme and communicating it to
the programme managers so that any
deviation from the planned operations
are detected, diagnosis for causes of
deviation is carried out and suitable
corrective actions are taken.

38. 46
EVALUATION
It is a systematic way of learning from experience
and using the lessons learnt to improve current
activities and promote better planning by careful
selection of alternatives for future action

39. 49
PLANNING CYCLE
Assessment
of health need
Establish goals
&objectives
Assessment of
resources
Establish
ment of
priorities
Design
alternative
program
Select the
best
alternative
Action
plan
Time frame
Implementation
of programme
Monitoring
Evaluation GOALS &
OBJECTIVES
No
Yes

40. 50
Types of Evaluation
• Total Evaluation
• Partial Evaluation
• Time related Evaluation
• Eye wash Evaluation
• Whitewash Evaluation
• Submerged Evaluation
• Concurrent evaluation
• Terminal evaluation
• Pre-evaluation
• Internal evaluation
• External evaluation

41. 51
TOOLS OF EVALUATION
• Review of Records
• Monitoring
• Case studies
• Qualitative studies
• Controlled experiments and intervention studies
• Sample surveys

42. 52
Who is performing Evaluation?
• The planner
• Adhoc research group
• Those responsible for health development
• Those responsible for implementation
• By the Community

43. 53
• What is to be evaluated?
• At what level is the evaluation is to be made?
• What is the purpose of evaluation?
• What are the constraints that could limit the utility of
evaluation?
• Basic steps of Evaluation
• Establishing standards and criteria
• Planning and methodology
• Collecting data
• Analyzing the data
• Taking action
• Re-evaluation

44. 54
What is to be Evaluated?
• Evaluation of structure
• Evaluation of Process
• Evaluation of Outcome

45. 55
Process of Evaluation
The process of evaluation consists of the
following components:
1. Specify the particular subjects
2. Information support
3. Verify relevance
4. Assess adequacy
5. Review progress
6. Assess efficiency
7. Assess effectiveness
8. And assess impact