This document discusses concepts related to public awareness and health education. It begins by outlining objectives of recognizing the concept of public awareness, basic components of communication and education processes, and health education theories. It then provides details on raising public awareness, including that the process must meet mutual needs and influence community attitudes/behaviors. Key approaches to awareness raising are discussed, including personal communication, mass communication, education, and advocacy. Several behavioral models are examined at the individual, interpersonal, and community levels, including the health belief model, stages of change model, diffusion of innovations theory, and community organization approach. Communication challenges and factors influencing complexity are also reviewed.

1. THE CONCEPT OF PUBLIC
AWARENESS AND HEALTH
EDUCATION
Professor Tarek Tawfik Amin
Public Health
Cairo University
amin55@myway.com

2. Objectives
By theend of thissession traineeswould beable
to:
1. Recognizetheconcept of public awareness
and itsvaluein health education.
2. Thebasic componentsof communication and
education processes.
3. Thebasic theoriesof health education and
themeritsof each.

3. Introduction
o Awarenessisabroad and vagueterm, yet
intuitively widely understood.
o It isapermanent-interactive-planned
communication processwhich opensopportunities
for:
1. Information exchange in order to improvemutual
understanding of ahealth problem and
2. To develop competenciesof theindividualsand
3. Skillsnecessary to enablechangesin social attitude
and behavior.

4. Raising public awareness
o To beeffective, theprocessmust meet and maintain
themutual needsand interests of thoseinvolved
(Providers-patients).
o Theultimateobjectiveisto influencecommunity
attitudes, behaviorsand beliefs that isreflected in
positively favorable outcome.

5. Public awareness
o Thetheory and practiceof public health
awarenessbased on:
- Masscommunication and
- Social or "social change" marketing.
o Social “change” marketing: communicating or
selling a'good idea' with thestated objective
of changing community attitudesand actions.

6. Communication
Effectivecommunication formsthebasisof all
social marketing and public awareness-raising.
"anegotiation and exchangeof meanings, in which
messages, people-in-culturesand 'reality' interact
so asto enablemeaning to beproduced or
understanding to occur."

7. Communication
Communication asathree-partsprocessby
which we
(1) Transmit and
(2) Receiveinformation
(3) Makesenseof themessageor messages
embedded in theinformation.
This finalpart o f the co mmunicatio n pro cess is
typically the least successful.

8. Communication: challenges
✦ Communication isomnipresent and inescapable- it's
everywhere! Thechallengeisto separatequality from
quantity.
✦ Communication isirreversible- oncesaid or
published it cannot beundone. Opportunitiesfor
misunderstanding and misinterpretation.
✦ Communication iscomplicated- thedegreeof
complexity isoften determined by factorsthat wecan
anticipateand to someextent control.

9. Communication
Critical factorsinfluencecommunication
complexity:
1. Channel or medium used
2. Personal experiencesand opinionsof the
communicators(speaker and listener, writer
and reader)
3. Environmental factors

10. Communication: Common environmental factors
✦ Thephysical spacein which thecommunication is
occurring - meeting room
✦ External distractionsthat causethemessageto be
missed or, misunderstood
✦ Credibility of thecommunicator - can I believethis
person?
✦ Listener or reader'slevel of education and
background knowledgeof thetopic.
✦ Design of themessage- isit appropriateto the
audience?

11. Communication process
Receiver Communicator
Media
Message
Interpretation
Inescapable
Irreversible
Complicated
Background knowledge
Educational status
Norm reference
Ingrained attitude
Credibility
Skills
Physical environment
Distracters
?
Language, culture, personal, lost information

12. 1- Communication usually fails, except by accident
✦ Languagedifferences: Poorly written and heavily
abbreviated.
✦ Cultural differences: Bigger and morediverse
audience, themorelikely it isthat someonewill
misunderstand your message.
✦ Personal differences: Even homogenoussocietiesor
communitiesarecomprised of individualswith
different lifeexperiencesand opinions.
✦ Lost information: Missed critical information through
inattention or thefailureof aspecific medium.

13. Communication; furtherreasons to fail.
2. If amessagecan beinterpreted in several
ways, it will beinterpreted in amanner that
maximizesdamages
3. Thereisalwayssomeonewho knowsbetter
than you.
4. Themorewecommunicate, theworse
communication succeeds. Theproblem of
reinforcement and propaganda.
5. Themoreimportant thesituation is, themore
probably you forget an essential thing.

14. Communication - Hearing, Seeing and Doing
"Tell me, and Iwill forget. Show me, and I
may remember. Involve me, and Iwill
understand."
Confucius, circa450BC

15. Learning
o Our effectivenessascommunicatorsrelieson
two key senses: sight and hearing.
o Adultslearn best when what they seeand hear
isreinforced with action.

16. Consider
Welearn 1% through taste
1.5% through touch
3.5% through smell
11% through hearing
83% through sight
Weremember 10% of what weread
20% of what wehear
30% of what wesee
50% of what weseeand hear
80% of what wesay
90% of what wesay and do

17. Point to be considered in awareness raising
1. Know yourpurpose.
2. Let yourpurpose guide and inform yourmessage
3. Know youraudience - communicate with the right
people and be mindful of theirsocial, cultural and
educational backgrounds
4. Anticipate problems and find solutions ormanage the
risk
5. Ensure credibility with youraudience - trust is vital
6. Present information using a variety of approaches and
techniques but ensure each is appropriate to your
purpose, message and audience
7. Communicate a little at a time - quality overquantity
8. Assume that any communication has been unsuccessful
until you have evidence to the contrary.

18. Key components MAST
Therearefour key componentsof an effective
awarenessraising:
1. Message
2. Audience
3. Strategy
4. Timing

21. Awareness raising Approaches
The more commonly used approaches may be grouped
into five broad categories, with each describing its
primary approach oremphasis:
1. Personal communication
2. Mass communication
3. Education
4. Public Relations (PR)
5. Advocacy

23. HEALTHEDUCATION BEHAVIORMODELS ANDTHEORIES
Current models/theoriesthat help to explain
human behavior related to health education,
can beclassified on thebasisof being
directed at thelevel of:
a) Individual (Intrapersonal);
b) Interpersonal; or
c) Community.

24. Individual (Intrapersonal) Health BehaviorModels/Theories
TheHBM can beoutlined using four constructswhich represent
theperceived threat and net benefits:
1) Perceived susceptibility, aperson'sopinion of thechances
of getting acertain condition;
2) Perceived severity, aperson'sopinion of how seriousthis
condition is;
3) Perceived benefits, aperson'sopinion of theeffectiveness
of someadvised action to reducetherisk or seriousnessof
theimpact; and
4) Perceived barriers, aperson'sopinion of theconcreteand
psychological costsof thisadvised action
1-Health Belief Model (HBM)

25. HBM

26. Individual (Intrapersonal) Health BehaviorModels/Theories
Behavior changeisviewed asaprocess, not an
event, with individualsat variouslevelsof
motivation or "readiness“ to change.
Sincepeopleareat different pointsin this
process, planned interventionsshould match
their stage.
2- Stages of Change Model orTranstheoretical Model

27. Stages of Change Model orTranstheoretical Model
1) Precontemplation - theperson isunawareof theproblem or
hasnot thought seriously about change;
2) Contemplation - theperson isseriously thinking about a
change(in thenear future);
3) Preparation - theperson isplanning to takeaction and is
making final adjustmentsbeforechanging behavior;
4) Action - theperson implementssomespecific action plan to
overtly modify behavior and surroundings;
5) Maintenance - theperson continueswith desirableactions
(repeating theperiodic recommended stepswhilestruggling to
prevent lapsesand relapse; and
6) Termination - theperson haszero temptation and theability
to resist relapse.

28. Stages of behaviorchange

29. Robinson's solution to identify seven steps (Doors) to social change:
1. Knowledge- knowing thereisaproblem
2. Desire- imagining adifferent future
3. Skills- knowing what to do to achievethat future
4. Optimism - confidenceor belief in success
5. Facilitation - resourcesand support infrastructure
6. Stimulation - acompelling stimulusthat promotes
action
7. Reinforcement - regular communicationsthat
reinforcetheoriginal messageor messages

32. Individual (Intrapersonal) Health BehaviorModels/Theories
o Developed out of thestudy of human problem
solving and information processing.
3- ConsumerInformation Processing Model (CIP)

33. CIP
CIPisacyclical processof information
search, choice, useand learning, and feedback
for futuredecision-making.
Beforepeoplewill usehealth information, it
must be:
1. Available,
2. Seen asuseful and new,
3. In afriendly format.

34. Individual (Intrapersonal) Health BehaviorModels/Theories
 Thistheory isbased on theassumption that
most behaviorsof social relevanceareunder
willful control.
 In addition, aperson'sintention to perform (or
not perform) thebehavior istheimmediate
determinant of that behavior.
4-Theory of Reasoned Action

35. Interpersonal model
Social networkshavecertain typesof characteristics:
1) Structural:
size(number of people) and
density (extent to which membersreally know oneanother)
2) Interactional:
reciprocity (mutual sharing),
durability (length of timein relationship),
intensity (frequency of interactionsbetween members), and
dispersion (easewith which memberscan contact each other)
3) Functional:
providing social support,
connectionsto social contactsand resources, and
maintenanceof social identity.

36. Social support refersto thevarying typesof aid that aregiven to membersof a
social network.
Research indicatesthat therearefour kindsof supportivebehaviorsor acts:
1) Emotional support - listening, showing trust and concern;
2) Instrumental support - offering real aid in theform of labor, money,
time;
3) Informational support - providing advice, suggestions, directives,
referrals; and
4) Appraisal support -affirming each other and giving feedback.

37. Community Level Models/Theories
 Thephrase Community Organization has
emerged from peopleas

they attempt to "definetheir own goals,

mobilizeresources, and

develop action plans" for meeting their
identified needs
1- Community Organization

38. Community model
o Diffusion of InnovationsTheory providesan
explanation for how new ideas, productsand
social practicesdiffuseor spread within a
society or from onesociety to another.
2- Diffusion of Innovations Theory

40. Characteristics of successful diffusion efforts
1) Relative advantage - an innovation isperceived as
better than theideait attemptsto replace;
2) Compatibility - being consistent with theexisting
values, past experiencesand needsof thepotential
adopters;
3) Complexity - innovation isviewed asdifficult to use
and understand;
4) Trialability orFlexibility - an innovation can be
experimented with on alimited or "trial" basis;
5) Observability - theresultsof an innovation can be
seen by others.

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43. Thank you