Interdisciplinary Health Promotion 2017 · 2018-01-22 · 7 Welcome to the Interdisciplinary Health...

University of the Western Cape Faculty of Community & Health Sciences

& Faculty of Dentistry

Interdisciplinary Health Promotion

2017

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Acknowledgments This course was collectively conceptualized in 2000 by the following persons: Firdouza Waggie, Natalie Gordon, Rina Swart, Nikki Schaay and Glynnis Vergotine. Course Convenor: Dr Firdouza Waggie. The teaching team 2017: Dr F. Waggie, Ms N. Adom-Aboagye, Ms L. Jaffer-Wingrove, Ms L Ganci, Ms R. Hara, Ms C. Swinny, Ms E Harris, Ms V Madasa, Ms L Kock and Ms F. DeJongh Fieldworker: Ms Labeeqah Jaffer Administrator: Mrs Janine Calvert-Wood

Corresponding author: Dr Firdouza Waggie Interprofessional Education Unit (IPEU) Faculty of Community & Health Sciences University of the Western Cape Private Bag X17 Bellville 7535 Tel: +27 21 9593627/2062 Fax: +27 21 9592606 E-mail: [email protected] Copyright © Faculty of Community & Health Sciences, University of the Western Cape, 2017

mailto:[email protected]

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CONTENTS

MODULE DESCRIPTOR

PART 1 - COURSE INTRODUCTION

Welcome to the Interdisciplinary Health Promotion course Course arrangements Lecturers & Facilitators for 2017 Overview of Sessions Assessment & Assessment tasks

PART 2 - COURSE SESSIONS

SESSION 1– Introduction to Course and Interprofessional Collaborative Practice SESSION 2- Planning Framework for Health Promotion Projects Preparation for health promotion in schools SESSION 3– Health promotion in schools

SESSION 4– Health promotion in schools




SESSION 8- Health promotion in schools

SESSION 9- History and milestones of health promotion SESSION 10-Health promotion models & interventions

SESSION 12–Poster & Group Report preparation

SESSION 13- Poster Presentations

MODULE DESCRIPTOR 1.1 Overview & purpose The purpose of this course is to equip the students with the basic knowledge and skills in understanding the concepts of health promotion. These concepts are applied in a particular setting, i.e. a school in a low socio-economic community. Students are expected to plan, implement and evaluate health promotion projects in the school. The health promoting schools framework is used to guide students. Students spend 50% of the course time in the community and 50% is spent on campus. 1.2 Module code: Dietetics: IHP211

Physiotherapy: IHP211 Occupational Therapy: IHP211 Social Work: IHP211 School of Natural Medicine: IHP211 Dentistry & Oral Health: HPD 111

1.3 Credit value: 10

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1.4 Duration: Semester 1.5 Module type: Faculty 1.6 SAQA level: 6 1.7 Pre-requisites: Primary Health Care 1.8 Co-requisites: None 1.9 Prohibited combinations: None

2. OUTCOMES 2.1 Critical Cross field Outcomes Students will be able to:

a) identify and solve problems* b) work in a team* c) organize and manage themselves* d) collect, analyze and evaluate information* e) communicate effectively* f) use science and technology* g) recognize problem solving contexts* h) reflect on and explore effective learning strategies* i) participate as a responsible citizen* j) be culturally and aesthetically sensitive* k) explore education and career opportunities l) develop entrepreneurial opportunities

2.2 SPECIFIC OUTCOMES Understand the main approaches to health promotion and that health promotion

requires not only individual behaviour change but also social, political and environmental changes that address the underlying causes of ill-health.

Apply the principles and approaches of the health promoting schools framework and to use this framework when planning and implementing a health promotion project in the schools.

Analyze the impact of the media and research on health promotion strategies.

Critically reflect on their community-based learning experience.

Demonstrate skills and professional conduct such as punctuality, participation and attendance when working in interdisciplinary groups and at the schools.

3. TEACHING METHODS Lectures

Small Group Work Facilitation Presentations Service-learning E-teaching

4. MAIN CONTENT Background and history of Health Promotion and Health Promoting Schools

Determinants of Health

The theory and application of health promotion models

Importance of accessing information for health promotion

The role of communication in health promotion

The planning cycle: identifying the needs, writing objectives, deciding on indicators and developing an action plan, project implementation & methods of evaluation

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Analysis of health promotion policies

5. STUDENT LEARNING RESOURCES 1. Recommended reading list (all these books are available in UWC library): 2. Healey, BJ. & Zimmerman Jr, RS. (2010).The New World of Health Promotion.

New Program Development, Implementation, and Evaluation. 3. Whitman, VC. & Aldinger, CE (2009). Case studies in Global School Health

Promotion. From Research to Practice. Springer Science & Business Media, New York, United States.

4. Hubley, J. & Copeman J. (2008) Practical Health Promotion. Polity Press, Cambridge, UK.

5. Laverack, G. (2007). Health Promotion Practice. Building Empowered Communities. Open University Press, Berkshire, England.

6. Coulson, N., Goldstein, S. & Ntuli, A. (1998). Promoting Health in South Africa: An Action Manual. Heinemann: Sandton.

7. Student manual compiled and additional learning resources can be found on the e-teaching website on https://ikamva.uwc.ac.za.

6. OUTCOMES, ASSESSMENT CRITERIA & TASKS Specific Outcomes Assessment Criteria Assessment Tasks

1. Understand the main approaches to health promotion and that health promotion requires not only individual behaviour change and curative care but also social, political and environmental changes that address the underlying causes of ill-health.

Understand the concept of health promotion.

Develop a suitable definition of health promotion.

Understand the main events that influenced the health promotion movement.

Explain the major elements of the following health promotion theories: health belief model, social learning theory and community action for health.

Link a theory or a combination of theories with the problem that needs to be addressed and to programme planning.

Have developed an understanding of the different factors /aspects that influence health behaviour and behaviour change of an individual.

Demonstrate an understanding of community participation as a health promotion strategy and the need for mediation, negotiation and enablement to ensure community participation.

Examination

Report

Reaction paper

2. Apply the principles and approaches of the health promoting schools framework and to use this framework when planning

Explain and describe the settings approach to health promotion.

Know the background of the health promoting school initiative

Know the definition of a health

Examination

Presentation

Report

Reaction paper

http://eteaching.uwc.ac.za/

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and implementing a health promotion project in the schools.

promoting school

Understand the health promoting school framework.

Understand the aims of a health promoting school.

Know the steps in the planning cycle.

3. Analyze the impact of the communication and research on health promotion strategies.

Demonstrate an understanding of the importance and challenges involved in selecting and appropriate communication strategies to promote health.

Understand what type of information is useful for health promotion and where to access this information.

Understand the importance of accessing information before planning a health promotion programme.

Examination

Presentation

Reaction paper

4. Critically reflect on the service-learning experience.

Critically reflect on a particular incident during the experience in the school.

Critical Incident Reflective Journal

5. Demonstrate professionalism such as punctuality, participation, respect, attentiveness, responsibility, competence and responsiveness when working in the interdisciplinary groups and at the schools.

Attendance of classes and school visits

Participation in group activities and plenary feedback sessions

Participation in the presentation and production of the report.

Peer Evaluation

Professional Conduct Form

Reaction paper

7. STUDENT ASSESSMENT Students will be assessed by continuous assessment and an examination. The examination will take place in the October/November Examination period. Continuous Assessment (70% toward final mark)

Group Report = 40%

Group Project Poster Presentation =15%

Critical Incident Reflective Journal =15%

Three Reaction Papers = 30 %

Professional Conduct Examination (30% toward final mark)

Examination = 100% Sub minimum The sub minimum rule of the university will apply i.e. if you score less than 40% in the continuous assessment you will not qualify to write the examinations. If you do not score 40% in the continuous assessment AND 40% in the examination you will not pass the module.

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Welcome to the

Interdisciplinary Health Promotion Course Dear Students Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love. Health is created by caring for oneself and others, by being able to take decisions and having control over one's life circumstances, and by ensuring that the society one lives in creates conditions that allow the attainment of health by all its members. The domain of health promotion has the potential to support this notion of health. However, health promotion is dependent on a number of critical issues such as the theoretical foundations and approaches taken in programmes, the application of health promotion theory to real-life contexts, working as an interprofessional team and importantly, a clear understanding of the intentions and outcomes of the health promotion programme. Caring, holism, equity and social justice are essential values in developing strategies for health promotion. Therefore, those involved should take as a guiding principle that, in each phase of planning, implementation and evaluation of health promotion programmes, the engagement of people and their communities as well as other stakeholders are essential in addressing the inequities and to advocate for change. The Interdisciplinary Health Promotion course is presented to second year health science students. It is a core interdisciplinary course and is seen as a continuation of the Primary Health Care course as it provides you with an opportunity to practically implement some of those learnt principles and concepts. This course has been jointly planned by staff from a number of departments in the Faculties of Community and Health Sciences and Dentistry at the University of the Western Cape and in partnership with the educators from schools in the Delft, Belhar and Wesbank communities, Cape Town. The course constitutes one module (10 credit points) and is offered during the third and fourth terms, periods 3 & 4 on Thursdays of the 2016 academic calendar. The following departments are participating in the course: Occupational Therapy, Oral Hygiene, Dentistry, Physiotherapy, Dietetics, Natural Medicine and Social Work. The IPEU team is looking forward to working with you on this exciting course and hope that it will be an educational and fulfilling experience. Dr Firdouza Waggie Course Convenor July 2017

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Course arrangements The course constitutes lectures, small classroom sessions and service-learning sessions at primary schools in Delft, Behar and West Bank. You will be allocated to lecture venues for the lectures and to smaller classroom venues for the classroom sessions. Please consult the departmental notice board for the dates and venues of the lectures. This information can also be found on the https://ikamva.uwc.ac.za website.

Which class are you in? A class number will be allocated to your class. Please consult your second year, departmental notice board for your class number, venue and name of your facilitator or https://ikamva.uwc.ac.za. You will not be allowed to enter a class where your name does not appear on the class list so please check the notice board and proceed to your assigned class! Lectures and class sessions are offered on Thursdays during semester 2, from 11am-1pm during periods 3 & 4. How should this student workbook be used? This student workbook is set out so that each weekly session is outlined with its tasks, online tasks as well as additional readings. It is therefore important that you have the relevant sessions and sections of the student workbook with you at each session. You will see that there are spaces for you to write notes or answer questions in the workbook. It also gives you guidelines on the outcomes of each session and what is expected of you during each session. The workbook highlights self-study sections which are important preparation for the following sessions. This workbook can be found on the e-teaching website https://ikamva.uwc.ac.za. Hard copies are also available for purchase at Printwize in the Student Centre.

Student notices & queries Communication regarding the course is sent to you in a number of ways. Communication about the course will be on the e-teaching website, https://ikamva.uwc.ac.za. You have been added as a student on the Interdisciplinary Health Promotion Course. Please visit the e-teaching website on a daily basis to keep you up-to-date with the course. Announcements will also be sent to your student email address and notices will also be posted on the notice boards in your discipline-specific departments. If you have any queries e.g. marks, timetabling, etc., please consult with your facilitator first. Your facilitator will also keep a record of your attendance, report, test and practical test marks. You can also consult the course administrator for any further queries:

Please note that should you have any formal complaint, the process to follow would be to first consult your facilitator then the course convenor and, should you not be satisfied with the outcome, you would then consult the Faculty Manager, Mr. M. Simpson. Online submissions All assessment tasks need to be submitted to the DROPBOX functionality on the https://ikamva.uwc.ac.za for your class. You will find your name in the DROP BOX where you will upload your assessment tasks. You will also hand in a hard copy of your work to your facilitator.

Mrs Janine Calvert-Wood

Administrator School of Public Health

Building, Room 2.05

021 959-2062 [email protected]







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Transport to schools You will be transported to your assigned school in the community. You need to meet your transport and facilitator at the departure point, which is at the swimming pool at 10h45. The buses will be clearly marked with the school where you have been assigned to. Please be punctual! Should you miss the bus, you will have to get there on your own.

Social Media & Ethics Please note that whilst you are encouraged to include pictures in your poster, you are required to obtain permission before taking any pictures or videos at the schools. Any pictures or video material of the schools and learners are to be used for the purposes of this course only and can be shared on the Facebook group i.e. Interprofessional Education at UWC on https://www.facebook.com/groups/334524910053854/. Once you have ‘liked’ the Facebook group you will be able to post to the group. We encourage you to share your experiences on this Facebook group. See https://ikamva.uwc.ac.za where you can find the consent forms for the participants.

Course Evaluation It is important to be critical of how you are taught and what you learn so that you can make constructive suggestions for improving the course. At the end of the course you are expected to reflect on, evaluate what happened in class, and how effective it was in achieving the stated objectives. Therefore, it is important and compulsory that you complete the course evaluation form accurately so that the facilitators can improve their teaching and the course on a continuous basis.

Compulsory attendance This is a core course for second year Health Sciences, Dentistry & Oral Hygiene students and it is a practical community-based course and therefore attendance of all classes are compulsory. A register will be signed at the end of each session. You should submit written proof, i.e. a medical certificate if you are unable to attend any of the sessions. The attendance register will also be taken into account when a discrepancy arises during the promotion process.

PLEASE NOTE!!! If you were absent from your service-learning or failed to hand in the critical incident reflective journal and online tasks or failed to contribute to the group report and/or failed to contribute or were absent from the poster presentation you will not qualify to be reassessed and you will have to repeat the module the following year.

Continuous Assessment Tasks and Due Dates:

No Due Date Assessment Task

1 24 August 2017 Reaction Paper 1

2 14 September 2017 Reaction Paper 2

3 12 October 2017 Reflective Journal

4 26 October 2017 Reaction Paper 3

5 9 November 2017 Poster Presentation

6 9 November 2017 Group Report

https://www.facebook.com/groups/334524910053854/


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LECTURER FOR BIG GROUP LECTURES NAME VENUE CONTACT DETAILS

DR. F. WAGGIE S1 X3627 – [email protected]

HEALTH PROMOTION FACILITATORS 2017

CLASS NAME CONTACT NO VENUE SCHOOL

1 MRS R. HARA [email protected] S1 SOCIAL SCIENCES

RIEBEECK STREET - Mr. Cloete 021 952-1250 - Fax: 0875174813 Coordinating Educator: Ms. Abrahams

2 MS N. ADOM-ABOAGYE

[email protected]

S2 SOCIAL SCIENCES

WESBANK NO.1 - Mr. Gordon 021 955-0777 - Fax: 021 955-0779 Coordinating Educator: Ms. Jeffreys

3 MS E HARRIS [email protected]

ME 36 HUMAN ECOLOGY

LEIDEN – Mr. Malgardy 021 954-2662 - Fax: 021 954-2667 Coordinating Educators: Ms. Gobile/Mr. Carelse

4 MS F DEJONGH [email protected]

D13 DENTISTRY PRE-

CLINICAL

RAINBOW - Mr. Bruintjies 0746886261 – Fax: 0862932300 Coordinating Educator: Ms. Filmalter

5 MRS. C SWINNY [email protected]

N98 NEXT TO ICS

DELFT – Mrs. Botha 0845868491 Coordinating Educator: Ms. Jenneker

6 MS L GANCI [email protected]

OB PREFABS

ROSENDAL – Mr. Jansen 021 956-5912/5169 - Fax: 021 956-1980 Coordinating Educator: Mr. Bam

7 MS V MADASA [email protected]

OM PREFABS

EINDHOVEN - Mr. H. Jansen 021 955-1171/5468 - Fax: 021 955-1499 Coordinating Educator: Ms. Jantjies

8 MS L KOCK [email protected]

E3 DENTISTRY PRE-

CLINICAL

GARDENIA – Mrs. F. Petersen 021 952-5817- Fax: 021 952-9850 Coordinating Educator: Mr. Arries

9 MRS L JAFFER-WINGROVE [email protected]

ROOM 25 PHYSIOTHERAPY

BUILDING

THE HAGUE – Mr. Zeeman 021 956-8900 - Fax: 021 956-8901 Coordinating Educator: Mr. America











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Course Sessions 2017 Semester 2 Content Overview Assessment Tasks Due

Dates Session 1 10 August 2017 Venue: Main hall

Introduction to the course and to interprofessional collaborative practice

Session 2 17 August 2017

Planning framework for health promotion Projects. Prepare for service-learning in schools


Health Promotion in Schools Self-study

Reaction Paper 1:


Health Promotion in Schools

Session 5 7 September 2017




Reaction Paper 2:





Session 9 12 October 2017 Venue: S1

History and milestones of health promotion. Health Promotion in South Africa.

Reflective Journal


Health Promoting Schools.


Health promotion approaches, interventions & communication.

Reaction Paper 3:

Session 12 2 November 2017

Poster & Group Report Preparation Course Evaluation

Session 13 9 November 2017 Venue Main Hall

Poster Presentations Poster Presentation Group Report

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Assessment & Assessment Tasks You will be assessed by continuous assessment and an examination. Continuous assessment contributes 70% towards the final mark and the examination contributes 30% towards the final mark. Continuous assessment

1. Group Report Your group will complete a report that will be handed in for marking. This mark will contribute 40% towards your continuous assessment mark. It is important for you to write a report about your health promotion project. This report has many functions, one of which will serve as an assessment of your health promotion project. The report will also inform the school and the university what your group has achieved in the school. It will also serve as a basis for your poster. The report will contribute 40% towards your continuous assessment mark. The report should not exceed 2500 words.

Instructions 1. Your report has to be typed with clear headings as indicated below. 2. The cover page of your group report should contain the following information:

a. Name of University. b. Name of Unit (Interprofessional Education Unit (IPEU), CHS). c. Name of facilitator. d. Name, surname and student number of students. e. Name of school. f. Date: year g. The title of the project.

3. Please upload the report in the drop box folder on the https://ikamva.uwc.ac.za platform. 4. Late submissions will be noted and the university rules will apply.

Due date is on the 9 November 2017 Below is a format for your report and mark allocation for the content of the report.

Interdisciplinary Health Promotion Course Group Report Rubric

Facilitator Name: ____________________________ Class No: __________ Group No: _________ Project Title: ______________________ School:____________________________

Report component (Subtitles)

Objectives that each component of the report must achieve

Mark Allocation

Title, Authors etc.

A succinct title indicating what the project is about, and utilizing a few key words to catch the reader’s attention. Include the names of the group members and facilitator. Identify 3-5 key words of your project.

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Introduction Background of the school: where is it situated, how many pupils, how many teachers, how many grades are at the

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school, extra-mural activities, school motto, governing body, your own impressions of the school, etc. What are the main challenges at the school? What is the broad purpose for doing the project? Is it based on an identified need? What does the literature say about this problem and your project? How does it fit into the school setting/context particularly within an action area(s) of the health promoting school, in which it will eventually be applied?

Situational analysis/ problem statement

How did you go about ascertaining the needs and what is already known about the problem (literature review)? There has to be a method you used to get the information /evidence you require. It must include target audience, data collection process and analysis.

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Aims/objectives

What is it that you would like to address in your project? State the aim and objectives of the health promotion project.

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Implementation

It simply describes the main features of the health promotion project. Who was the target audience? When did it occur? What resources did you use? Describe the activities. What were your indicators? Who was involved?

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Discussion

In this section you need to reflect on your process of developing and implementing your health project project. and did you meet them. Discuss the process of how you evaluated your project. What were the outcomes? Did you achieve your aim and objectives? Show how your project linked with the health promoting schools framework, and other current literature as it pertains to your project, strengths and weaknesses of your project.

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Conclusion What is the final answer to the identified needs based on what you discovered through your project? Unanswered questions and future research. Implications for future students and others involved in the school.

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Recommendations If there is a practical suggestion that arises directly out of your health promotion project, this can be stated here.

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Report Presentation General Presentation

Cover Page. Content page. Page Numbers. Introduction & conclusion. Typed, size 12 fonts, 1.5 line spacing.

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Structure Appropriate heading for each category of information. Sub-paragraphs when a new idea but related idea is shared. Logical connection between sentences, sub-paragraphs and

paragraphs. References

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Language Spelling. Grammar. Sentence structure.

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Content & Originality

The content of the assignment should cover the assignment questions as outlined

The work done to obtain the information must show initiative and creativity.

The assignment should reveal a style that indicates it is your own work and not plagiarized.

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Total Mark 100marks

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CONTRIBUTION OF INDIVIDUAL GROUP MEMBERS:

Student name Contribution Mark

General Comments: Assessed by: _____________________________________ Signature : _______________________________________ Date:______________________________________________

2. Poster presentation The poster presentation will take place at the university. Your poster will be assessed by a facilitator and your peers. This mark will contribute 15% to your continuous assessment mark. Each group will get 8 minutes to present their poster and 5 minutes for questions. Please stick to the time allocation. You will be penalized if you exceed your time allocation. Poster Specifications: Size: Minimum size is A1 (The A1 size print measures 594mm X 840mm). Notices for printing companies & costs will be communicated to you via ikamva.

POSTER PRESENTATION DAY: 9 November 2017

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INTERDISCIPLINARY HEALTH PROMOTION

POSTER PRESENTATION

Assessment

Group number:

Class:

Facilitator Name:

Title of Poster:

Select response most appropriate to statements below. Options are:

not done=0, no=1, somewhat=2, yes or good=3

Insert

response

Technical quality of poster

01. Poster text is easily legible from distance of at least 1 m

02. There is a balance between text and free space on poster

03. Tables and figures are used appropriately

04. Pictures and images used enhance quality of poster

Quality of content of the poster

05. Poster title captures essence of project

06. Rationale for project is clearly stated

07. Project interventions are clearly and concisely described

08. Key findings of project are clearly described

09. Outcomes of project are clearly stated

Quality of poster presentation

10. Rationale for project is clearly and concisely described

11. Outcomes of project are clearly articulated

12. Key findings of project are concisely described

13. Questions posed by audience are appropriately answered

Total /39

Comments:

Signature of Assessor: Facilitator__________________________ Student: ____________________________

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3. Reflective Journal Student journals are common reflection activities in service-learning courses. Journals provide a way for you to express your thoughts and feelings about your experience at the school. Please note that the journal entries are not a mere log of events but it is a reflective activity in which you consider your experience at the school in light of the learning objectives of this course. You will write a reflective journal at the end of your experience at the school and you need to upload it to the drop box on https://ikamva.uwc.ac.za. Late submissions will be noted and the university rules will apply. Your reflective journal will be assessed by your facilitator. The reflective journal will contribute 15% to your continuous assessment mark. You can also find the reflective journal questions under the course content on the website, https://ikamva.uwc.ac.za.

Critical Incident Reflective Journal: Instructions: 1. Your journal has to be typed with clear headings as indicated below. 2. At the end of your service-learning in the school you are expected to complete a reflective journal. Please submit your journal online on https://ikamva.uwc.ac.za. 7. Late submissions will not be accepted.

Interdisciplinary Health Promotion Course Critical Incident Reflective Journal

Name: ____________________________________ Student No: _________________________________ Facilitator Name: ____________________________ Class No: _________ 1) Description Describe as a matter of fact just what happened during your critical incident or chosen episode for reflection during your service-learning experience at the school. 2) Feelings What were you thinking and feeling at the time and why was this significant to you? 3) Evaluation List points or tell the story about what was GOOD and what was BAD about the experience. 4) Analysis What sense can you make out of the situation. What does it mean and what were the underlying issues? 5) Conclusion What else could you have done? What should you perhaps not have done? 6) Action Plan If it arose again, what would you do differently? How will you adapt your practice in the light of

this new understanding?




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Due date for the Reflective Journal is on the 12 October 2017

Interdisciplinary Health Promotion Course Critical Incident Reflective Journal Rubric

Name: ____________________________________ Student No: ________________________________ Facilitator Name: ____________________________ Group No: _________

OUTCOMES 1 (0% - 39%) 2 (40% - 59%) 3 (60% - 79%) 4 (80%+) Mark (%)

Presentation (P)

Disorganized with no logical flow. Untidy. Reflects little effort.

Disorganization at times. Reflects some effort.

Organized with contents page. Neat file. Strong effort.

Well organized. Very high quality. Excellent effort.

Reflection (R)

Superficial descriptions of events. No future action plan. Do not consider underlying issues at all. Not competent.

Adequate description of events. Inconsistent and unclear theory. Consider some underlying issues and future action plans. Show some insight.

Clear and precise description of events. Theory clear. Clear understanding of underlying issues. Show ample insight on how future plans can improve. Show good insight.

Clear and precise descriptions of events. Interpret events accurately with through theory. Excellent understanding of the underlying issues. Have good future plans. Excellent insight end sensitivity to events.

Final % (Presentation counts 20% and Reflection counts 80%)

FORMULA : PercentagexxR

xP

100

5

4

1005

1

100

TOTAL

General comments:

…………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………

Assessed by: _____________________________ Signature: _______________________________ Date: ____________________________________

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4. Reaction Paper You are expected to complete 3 reaction papers. A reaction paper is your response to an academic article. This will collectively contribute 30% towards your continuous assessment mark. You need to upload it to the drop box on https://ikamva.uwc.ac.za. Late submissions will be noted and the university rules will apply.

Reaction Paper Marks Due Dates

Reaction Paper 1 30 marks 24 August 2017

Reaction Paper 2 30 marks 14 September 2017

Reaction Paper 3 30 marks 26 October 2017

Examination You will write an examination during the November examination period. The examination will contribute 30% towards the final mark. Professional conduct As a future health worker it is expected that you present yourself in a professional manner at all times when working in the community. Your professional conduct will be assessed by the educator at the school at the end of the course. Professional conduct includes dress code. You will be required to wear you department uniforms when visiting the schools. Should your department not have a uniform, please wear a black/navy pants/skirt and a white sweater/shirt and nay blue jacket or the UWC branded jacket. Please ensure that skirts are knee-length and that sweaters are not body-hugging. No low necklines are allowed and no part of your midriff is allowed to show. Furthermore, no smoking is allowed on or near school premises.

University of the Western Cape Faculty of Community and Health Sciences

Professional Conduct form (The educator at the school completes this form)

Name of Student: ______________________________________ Student Number: ______________________________________ Course Facilitator: _______________________________________ Group Number: ________________________________________ Educator: _____________________________________________ Signature of Educator: ___________________________________ Scale: Excellent= 5; Very good = 4; Satisfactory= 3; Unsatisfactory= 2; Poor= 1-0

Indicators Grade Comments

1 Punctuality and neatness (includes dress code)

2 Professional interest and enthusiasm

3 Good rapport with educators and learners

4 Demonstrates team work

5 Demonstrates a professional manner with learners and educators

6 Time management

7 Uses initiative

8 Eager to improve general knowledge and practical skills

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Ability to work independently

10 Demonstrate effective communication skills


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SESSION 1: INTRODUCTION TO THE COURSE

“Learn together to work together” During this first session you will be introduced to the course and the interprofessional education and collaborative core competencies. There will be a focus on team work and communication. Get to know each other! You have been assigned to an interprofessional class and will work in an interprofessional team. In the next session you will be allocated your team, introduce yourselves and agree on the ground rules for your team. You will also be given an opportunity to set down the ground rules for your team. When we set the classes, we have tried our best to adhere to the following criteria:

Interprofessional - the individuals must be from different professional programmes; this is a very important criterion, since this is an interprofessional course

Multicultural – you should come from different cultural backgrounds

Different home languages, please ensure that at least one group member is proficient in the language of instruction of the class.

Different genders – mix the females and males as equitably as possible. You will remain in this interprofessional team for the entire duration of the course including the service-learning at the school. It is essential that you establish a good working relationship and understanding with your team members since much of your work in the class and at the school will depend on how well you function as a team. Thus lay down the ground rules first!!

In preparation for the next session, (1) please read Coulson, N., Goldstein, S. & Ntuli, A.

(1998). Promoting Health in South Africa: An Action Manual. Heinemann: Sandton. Chapter 13 pages 158-173. (2) familiarize yourself with the project planning cycle. See Diagram below.

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SESSION 2: A PLANNING FRAMEWORK FOR HEALTH PROMOTION PROJECTS Outcomes By the end of this session, you should be able to: 1. Know the steps in the planning cycle. 2. Understand the importance of doing a needs assessment before planning a health promotion

programme. 3. Understand what type of information is useful for health promotion and where to access this

information. 4. Write clear and measurable objectives. 5. Identify indicators that will be used to measure the objectives. 6. Know the differences between summative and formative evaluations. 7. Be able to write up aims for each evaluation method. 8. Have clear methods for evaluating a project. 9. Have developed an understanding of the purpose of evaluating a project. 10. Know which school and health promotion topic you have been assigned to 11. Know the logistical arrangements for the service-learning at the school. 12. Understand the steps in writing a critical incident reflective journal. During your service-learning at the school you are expected to plan, implement and evaluate a health promotion project at the school. To achieve this you will be introduced to the project planning cycle. This is a systematic approach that will serve as a guide and enable you to successfully implement your project. Please note that you will have six sessions at the school and therefore your health project needs to be manageable, realistic and efforts to sustain your project is vital. The project planning cycle –what is it? Below is a diagram of the project planning cycle that will guide you when planning and implementing your health promotion project at the school. Your facilitator will introduce you to it.

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The Project Planning Process Step 1: Needs Assessment/Situational analysis

: Conduct A needs assessment/situational analysis is done to clearly identify a health problem in a

community/school /institution etc.

A needs assessment thus means finding out how the persons that you are going to work with perceive, experience and express the problem. The persons that we are referring to will be part of the school, the community, the institution, etc. Task 1 In determining priorities the following questions should be answered.

Who is the target audience and what are their needs? (defined from their perspective)

You need to first decide on your target group. Is it going to be the educators, students, persons with disabilities, elderly persons, young mothers, support staff at the school, teenage girls and/or boys, which grades, etc?

For the purposes of this course the above information will be given to you by your facilitator. Your facilitator will thus inform you of the topic that you will be working on and hence you will develop a project based on this topic (more detail will follow during the session).

How are you going to determine their needs? You will consider using observation, interviews, health statistics, focus groups with the school community.

Which methods are you going to use? The method(s) should essentially enable you to identify the real needs of your target audience. Decide on your methodology!

Who contributes to the needs assessment? Members and structures of the school community, the health/social sector, as well as learners, parents, teachers and other sources of information as statistics, publications should all contribute. The scope of the project will determine how large the consultation process will be. Any needs assessment will benefit from drawing upon a wide range of individuals and organizations involved with working with your target audience and involving as many members or representatives of your target group as possible.

Decide on who & what you are going to include in the needs analysis process.

Where will you access the information?

Methods to determine needs:

1. 2. 3.

Target group:

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Step 2: Write Aim & Objectives In your first session at the school, you will meet the target group. During this session you will set clear and measurable objectives for your health promotion project. Objectives should relate to needs identified during the needs assessment process. Your objectives should clearly tell you what your project aims to achieve. Clear objectives are important to identify appropriate indicators that can be used to measure the success or failure of the project. After your objectives have been set, activities should be identified to reach the set objectives. At the end of this step you should be able to answer the question "What are we going to do?" and "How will we do this?" You may have come across objectives before and have heard that they must be S M A R T. S - Specific: For whom (target group); where (location)? M - Measurable: How much (quantity); how well (quality)? A - Achievable: Can this be achieved? R - Realistic: Can it be achieved in the time frame? T - Time-bound: By when? Task 2 Discuss and answer the following in your groups. What are we trying to achieve?

Set an aim - i.e. a broad statement of what your team is trying to do. Remember to base it on the identified need. (on the theme your received)

What are our objectives?

Set objectives to meet your aim, i.e. how will you reach your aim?

Where can we access the relevant information? 1. 2.

3.

Aim of the project:

Objectives of the project: 1. 2. 3.

.

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What are we going to do?

Select the best way of achieving your aim; look at various options that will most effectively convey your message.

Plan activity (-ies) to reach the set objectives; is (-are) the activity (-ies) appropriate and acceptable to the target audience.

Look at available resources.

Task 3 Action plan of your health promotion project: When are you planning to implement your health promotion project?

Draw up a schedule of dates, times, tasks etc. This should clearly indicate who should do what by when.

See the following pages and fill in.

Activity/ies: 1. 2. 3.

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Date 31August 2017

Target Group

Aim of health promotion project

Objectives

Indicators Process

Outcome:

Activities

Who will undertake the various tasks?

Resources needed

Evaluation

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Date 7 September 2017

Target Group


Objectives

Indicators Process

Outcome:

Activities


Resources needed

Evaluation

27


Target Group


Objectives

Indicators Process

Outcome:

Activities


Resources needed

Evaluation

28


Target Group


Objectives

Indicators Process

Outcome:

Activities


Resources needed

Evaluation

29


Target Group


Objectives

Indicators Process

Outcome:

Activities


Resources needed

Evaluation

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Step 3: Deciding on Indicators

Indicators are markers, which are used to measure the success or failure of a programme. There are two types of indicators:

Process indicators - these are tools for checking that the implementation of a project is

going as planned. You need to ask the question "How can we ascertain if we are on track?" Outcome indicators - these are tools for checking whether the objectives of the project

have been met. You need to ask the question “Have our objectives been met?”

Task 4 Your team needs to revisit the objectives of the health promotion project that your team has developed. Decide on process and outcome indicators which will measure the success of the project. Complete in the columns below.

Health Promotion Project Objectives

Process Indicators Outcome indicators

1.

2.

3.

Step 4: Project Implementation

Before implementation, the team leader should confirm with all the members of the team whether all the allocated tasks have been completed and if there are any changes to be made to the action plan.

Remember! An action plan serves as a map to guide those involved with the project as it progresses.

You should consult with your contact person (-s) about whether there is agreement on resources, venues, time, etc. and whether any changes are necessary.

The project can now be implemented.

Step 5: Project Evaluation

Task 5 Experts in the field highlight two types of evaluation, namely: formative and summative evaluation, which are very similar but with the main difference being timing. In your groups, brainstorm what these differences could be:

Formative: Summative:

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Down (2008) provides the following definitions of the above terms:

Formative evaluation: Conducted during the project to improve the work in progress and the likelihood that it will be successful.

Summative evaluation Conducted near the end of the project to provide evidence of achievements and success.

Task 6 Now in your groups, discuss how you would meet the aim of your project for both types of evaluations and report back to plenary. Task 7 This might seem like a simple task, but a very important one in terms of assessing whether you have met your aims or not. An evaluation is also essential in ensuring sustainability of your projects, in your case, if you would like the next group of students to pick-up where you’ve left off. Consider the following questions you might want to ask yourself or your group:

Formative questions Summative questions

Have milestones been met on schedule?

What is holding up progress? What should we do to correct this? Is project management effective? Are stakeholders on board? Do they agree with interim

findings? Is our dissemination effective? What lessons have we learned? Do we need to change the plan?

Have objectives been met? Have outcomes been achieved? What are the key findings? What impact did the project have? What benefits are there for stakeholders? Was our approach effective? What lessons have we learned? What would we do differently

Write down any questions you might want to ask your facilitator:

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Preparation for your service-learning and health promotion projects in the schools. 1. Your facilitator will introduce you to the teaching and learning approach of service-learning

which this course has adopted.

2. Your class has been assigned to a specific school. Your activities at the school will be jointly supervised by the educators and your facilitator.

3. Your facilitator will brief you on the school and target audience with whom you will be working.

Listen carefully to what he/she is saying as the information is valuable for the success of your project. This will entail the name of the educator, the class, the target group and the health promotion topic.

4. In order for you to plan, implement and evaluate your health promotion project successfully

and for your programme to be sustained it is suggested that your project be linked with any of the health promoting schools framework action areas. Your group will be evaluated in terms of this particular action area and whether the outcomes of your project were met. In order to make your project effective and successful you will be applying the project planning cycle. Each week you will be experiencing and applying the five stages of the planning cycle.

5. The CHS Faculty, in partnership with the school agreed on certain conditions before the

university is allowed to deliver a service, or use the school as a teaching and learning site. What are these conditions?

When we do our teacher evaluation of the course at the end of each term, the most popular comments are “…you are most welcome, but the student must behave properly and they must not waste our time…” These comments form the core of the agreements that we made with the schools. What do these comments translate to?

6. The following rules will apply to you on the school visits:

You should comply with the requirements stipulated in the Professional Conduct Form.

Attire: you should be neatly clothed in a UWC branded item of clothing (i.e. tshirt, hoodie), blue pants, or skirt (not shorter than knee length) or blue jeans.

Wear a name badge.

The use of cellphones are not allowed.

A school representative will welcome and orientate you to the school on the first school visit.

On the school visits thereafter, please proceed straight to your assigned venues on arrival and start with your planned activities. Please do not loiter. It is for your own safety.

7. The CHS faculty agreed on the following conditions with the schools:

Adhere to the language policy of the school. Use the official language of instruction of the class. Refrain from using slang. You will require the permission of the educator if you want to have the language conditions waivered. The educators are always sympathetic to the student’s plight.

As previously stated, you have to slot in with the planned project for the class. The educator sent the topics to us beforehand. Your facilitator will provide you with these topics. Certain topics may be perceived by you as not relevant to your profession. Please note that health professionals endeavour to promote health in all aspects of society and in an interprofessional team and therefore your project is a team effort with each profession and team member contributing to addressing the topic.

What if you find the topics too difficult? The facilitator can empower you to engage in dialogue with the school and the class educator. You will interview the educator on the

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school visit. During this interview you should be able to come to an agreement with the educator as to the topic for the health promotion project. The educators usually accommodate our student requests.

The educator planned that the learners reach certain outcomes, do certain activities and do certain assessment pieces in the time that you manage their learners. We agreed that you will ask the educator each week whether they have certain activities and assessment pieces or other preferred activities for the following week’s school session.

As a group, plan your first day at the school. Remember that even though you are a group of about 30 students, each group of 4 or 5 students will be assigned to different classes.

For the first school visit you should plan o To meet and interview the educator o Plan an ice-breaker and meet your target audience o Do your needs analysis, which should encompass finalizing the topics and other

aspects of presenting the sessions. o Give the Professional Conduct Form to the teacher. Explain to the educator that he/

she needs to complete it and hand it back to you on the last day of the school visit. This form you will hand over to your facilitator.

Task 1 In your group, have a brief discussion of how your conduct should be, refer to the Professional Conduct form below. Also have a short discussion on what you think the educators might mean with “time wastage” and “behaving properly”. Lay down the ground rules for your group. Lastly plan how you will do your needs analysis, your interview with the educator and your ice-breaker with the learners or target group.

University of the Western Cape Faculty of Community and Health Sciences

Professional Conduct form (The educator at the school completes this form)

Name of Student: ______________________________________ Student Number: ______________________________________ Course Facilitator: _______________________________________ Group Number: ________________________________________ Educator: _____________________________________________ Signature of Educator: ___________________________________ Scale: Excellent= 5; Very good = 4; Satisfactory= 3; Unsatisfactory= 2; Poor= 1-0

Indicators Grade Comments

1 Punctuality and neatness (includes dress code)

2 Professional interest and enthusiasm

3 Good rapport with educators and learners

4 Demonstrates team work

5 Demonstrates a professional manner with learners and educators

6 Time management

7 Uses initiative

8 Eager to improve general knowledge and practical skills

9

Ability to work independently

10 Demonstrate effective communication skills

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The Critical Incident Reflection Journal Soon you will be going to schools to implement a health promotion project. You need to complete a critical incident reflective journal based on your experience in the school. The next section will introduce you to what is expected to complete this task. Your facilitator will guide you in understanding how to write a critical incident journal. The critical incident journal is a type of reflective journal commonly used in service-learning courses. Reflection allows students to “…reach beyond the provision of service to learning from that service…it allows for connections to be made to prior knowledge and experiences and for a more profound understanding of the new experiences…effective critical reflection contains certain essential elements, it is: continuous, connected, challenging, and contextualized…” (Olson Rose and Bush Michelle, p29). You are required to hand in three critical incident journals for a mark. Your journals will be assessed according the criteria of the journal rubric and mark sheet. An average of the three journals will be submitted towards your continuous assessment mark. Below is the framework that will guide your reflection

In summary, check that you have discussed and recorded your discussion on the following items

1. Professional conduct

2. Effective use of time

3. Ground rules

4. Interview with the educator

5. Ice-breaker

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Gibbs Model for Reflection The Gibbs Model of Reflection is one of the most popular models for reflection, entailing a six step process which is one of the few models which take emotions into account. This model should be used as a guide for writing your critical incident journal. The Reflective Cycle

Six stages of GIBBS Reflective Cycle 1) Description

Describe as a matter of fact just what happened during your critical incident or chosen episode for reflection.

Working on an ambulance with my colleague, we received a call to a nursing home for an elderly female "fallen". When we arrived on scene we were met by staff who informed us that the lady had missed her seat as she went to sit down and landed heavily on the floor. Approaching the female I could see that the area she had landed on was carpeted and that she was of slight build and elderly and seemed in a great deal of pain. Her RIGHT leg was shortened and rotated.

2) Feelings

What were you thinking and feeling at the time?

My first concern was that this lady had obviously sustained a RIGHT hip fracture and had the potential of a serious internal bleed. I was also concerned whether it was indeed a simple 'slip' or whether there was any underlying condition that had caused her fall. Rao SS (2005) stated that causes of falls in older people are usually multi factoral but can include: Accident and environmental hazards 31%, Gait and balance disorders 17%, Dizziness and vertigo 13% Drop attack 9%, Confusion 5%, Visual disorders 2%, Syncope 0.3%, Arthritis, acute illness, drugs, alcohol, pain, epilepsy & falls from bed 15%, unknown 5%. I ascertained from my history taking that this lady suffered from dementia and was stage four on the Global Deterioration Scale as identified by B Reisberg, SH Ferris, MJ De Leon & T Crook (1982). This is described as Early Dementia and meant

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that she was at a stage in her condition where she could no longer function without assistance, was unable to recall major events, home address, phone number or names of her children. She was also taking more than 4 medications for this condition including drugs for depression which could have been a contributing factor as stated in the American Family Physician (2000).

I was also reminded of my grandmother who had suffered a fall recently. I wanted to make the patient as comfortable as possible as my grandmother’s experience had emerged strongly for me at this time.

3) Evaluation

List points or tell the story about what was GOOD and what was BAD about the experience.

I was pleased to see that the lady, although in a great deal of pain, appeared to have sustained no other outward physical injury. Her observations were within the normal range and her circulation appeared normal. My major concern was that this call had been classified 'green' in accordance with Government guidelines, and she had, therefore, been lying in this condition for over an hour.

4) Analysis

What sense can you make out of the situation. What does it mean?

This elderly female suffered with dementia but otherwise enjoyed good health. She lived in a nursing home specialising in care of the Elderly Mentally Ill. I was satisfied to learn that she had no previous history of falls and that there had been no change to her medication within the last two months, a recent report (American Family Physician, 2000) stated that the elderly were prone to falls following a change in medication. I was satisfied with her observations and that she appeared to be her normal self.

5) Conclusion

What else could you have done? What should you perhaps not have done?

I feel that the whole process went very smoothly, the lady received pain relief through an IV cannula thus making her move on to the ambulance trolley as smooth and pain free as possible. I explored the history thoroughly and I do not think there was anything that I should not have done.

6) Action Plan

If it arose again, what would you do differently? How will you adapt your practice in the light of this new understanding?

I will continue to reflect and study the causes of falls to further my knowledge. I will seek to contact the local Slips, Trips and Falls Team to gain advice on how they deal with patients who have falls regularly and to see whether I can perhaps put into practice some of their advice to better the service that I can provide to the elderly patient.

Adapted from: http://distributedresearch.net/wiki/index.php/Gibbs_reflective_Cycle (14 April 2010)

http://distributedresearch.net/wiki/index.php/Gibbs_reflective_Cycle%20%20(14

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Reaction Paper 1: Due date 26 October 2017

Read the article, Du Plessis LM, Koornhof HE, Daniels LC, Sowden M & Adams R (2014).

Health promoting schools as a service learning platform for teaching health-promotion

skills, African Journal of Health Professions Education, 6,1, 48-51. Answer the following questions after reading the article:

1. Discuss briefly the problem and what that the authors have identified and the

aim of the study. (5 marks)

2. Define Service-Learning in your own words and highlight the three main criteria

for service-learning. (8 marks)

3. Discuss why schools are considered as ideal settings as a service-learning

platform? (5 marks)

4. Discuss briefly the students’ experiences in relation to the educators with

regards to the Health Promoting Schools Initiative? (5 marks)

5. In your own words, write a brief response to the paper (200-250 words). (7

marks)

Total=30 marks

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Self Study Please read the following excerpt on observational skills. This will assist you in your service-learning at the school and during all aspects of the planning cycle. An Observation Guide for Service-Learning in the Schools: Dr Firdouza Waggie (Adapted from the handout compiled by Tara Carney, 2005)

An observation skill is an important skill for a health professional. As a student, you will be conducting research, and will work in a community and clinical settings and therefore this skill will is essential and will be used in both settings. The following is an observation guide for you going into the schools where you will be conducting a health promotion project. It is suggested that you not only require specific knowledge in order to conduct systematic observation, but you also need to be aware and reflect, in order to be empathic towards the target group who are being observed. Observation can be used on its own or in conjunction with interviewing. 1. Know yourself Firstly, you need to be self-aware. Before even going out into the field you need to be aware of what is happening in your own life, as well as your own biases and assumptions. If you are self-reflective, these issues may impose on your observations, and you may only concentrate on certain things, and interpret your findings in a subjective way that does not affect the reality of the situation. It is also to pay attention to your own responses and behaviours during the observation, for example if you find yourself becoming tense, begin to question ‘why’? 2. Are you going to be a participant, an observer or a participant-observer? The identity that you adopt will also depend on the context that you are in. If you are seen as over-friendly and not genuine, suspicious, intrusive or threatening, the community/ target group will not be willing to ‘’let you in’’ to their world. Remember, you are an observer, and not a member of the community/ target group. Having said that, you should still be as involved in experiencing the observational setting as you can without letting it bias the process of your service-learning and findings. Inter-personal skills are important here, as you will be working with people in their environment, and need to show empathy and understanding, even if you are not speaking with them directly as you would in an interview. 3. Look around carefully and describe the entire physical space and the people The important elements of observation are to focus and concentrate. Look at what is in front of you, and really see it. Pay attention to detail, and if in doubt, rather write down too much than too little. You need to stay alert and disciplined throughout the observation process. The difficulty in this stage is that you need to decide what to focus on, as you clearly cannot make notes about each and every aspect of the setting that you are in. The best idea is to look at what question you are actually trying to answer and work from there. For example, if you are looking at children behavior during break times, the children will be the people you observe. The context would be the school grounds, the prefects or monitors and the activities they engage in. 4. Gather information from a variety of different sources during the observation. Look at things such as buildings (school, clinics, community halls), playground, taxi ranks, as well as the people in the context. Firstly, concentrate on their physical appearance, including age, dress, hair colour as well as body language and actions. For example, are they walking in a stooped manner, are they avoiding eye contact, do they appear to be happy or unhappy and so forth. Non-verbal cues may be very useful to explain what is going on in the context. They may also indicate to you when you are not welcome and you need to respect this. 5. Pay attention to the seen and unseen Occasionally you may want to question what is not being seen or said. Draw on your interpersonal skill such as active listening which includes listening to the non-verbal behaviour and what is not being said.

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6. Record the observations Observation usually requires an observation schedule, but on your service-learning in the school we require you to take down notes, commonly known as field notes. You may also want to take photographs or draw diagrams. These notes will give you the opportunity to write down what is happening out in the field, but also try to write down some questions if you have any, or to make preliminary interpretive notes. For example, ‘’I notice that X keeps on shouting at his peers in the class. Check out what is happening if possible.’’ A common suggestion is to jot down key points.You need to strike a balance between writing notes and still paying attention to what is going on around them. If you have written down some key notes during the observation, a possibility is to write down the full notes directly after leaving the scene that you have observed i.e. in your personal journal. The disadvantage of waiting for a period until you write notes is that some of your descriptions and patterns noticed may be forgotten. Another suggestion is making notes about the observation, but also personal notes such as you own experiences and assumptions. 7. Interpret the Findings How do you interpret findings from you observations? Look for similar patterns in you field notes. In other words, look for patterns or themes that have come up in the notes more than once. Common examples of this are: a) Relationships between people and groups of people: what are the relationships like between

children and the educators working with them? Also consider what the relationships are like between the people in the community. The interpersonal skills that you have learnt should help you here.

b) Common characteristics amongst the people and the context you are observing: take note of similar characteristics such as age, gender, speech, activities as well as the environment playing ground, school buildings, broken windows and so on. This will assist you later when you are interpreting the data that you collected.

Draw conclusions about what you have discovered during you observation. Ask yourself what this means? Look not only towards the implication that this new knowledge may have on your specific health profession, but also reflect on what you experience and how did it change you personally? 8. Reflect Reflection should take place both during and after observation. It is suggested that it is included in your notes and are your own personal experiences, thoughts and feelings. Examples are: ‘I feel safe as an observer in this setting’’,’’ I felt overwhelmed by trying to note everything around me.’’ After you have worked with your notes, you may also want to reflect on what you have learnt either about yourself or new knowledge about the situation that you have observed. This step is especially important as observation is a highly personal experience, as it will depend on individual skills and decision-making, as well as any biases that have not been addressed in step 1. You now need to write this information in your critical incident journal, using the Gibbs Model of Reflection that you have been working with. References: Darlingon, Y & Scott, D. (2002). Qualitative research in practice: Stories from the field. Australia:

Allen & Unwin. Genzuk, M. (year unknown). A synthesis of ethnographic research. University of California: Centre

for Multilingual, Multicultural Research. Janesick, V.J. (2004).’’ Stretching’’ exercises for qualitative researchers (2nd ed.). Thousand Oaks,

California: Sage Publications Inc. Manson, J. (1996). Qualitative researching. London: Sage Publications.

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SESSION 3,4,5,6,7,8: HEALTH PROMOTION IN SCHOOLS Outcomes By the end of the first session in the school, you should have:

1. Met with the contact educator and target group. 2. Consulted and ensured participation from your target group about your proposed aim

objectives for your project. 3. A good understanding of the school context, challenges & priorities and strengths.

By the end of the second, third, fourth & fifth session in the school, you should have:

4. Implemented aspects of your action plan. 5. Gathered information for relevant aspects of the group report & poster presentation.

By the end of the sixth session in the school you should have:

6. Evaluate your action plan. 7. Feedback to the relevant person/s at the school and to your target group.

You will be going to your assigned school in the community. You should meet your transport and lecturer at the departure point, which is at the swimming pool at 10h45. The name of the school where your class has been assigned to will be clearly marked on the bus. Please be punctual!!!! During your first visit you will be introduced to the school and the surrounding community and your target group. DO NOT FORGET TO THANK THE PRINCIPAL, TEACHERS, & LEARNERS!!

SELF STUDY AFTER FIRST SCHOOL VISIT: REFLECTION & REFINE HEALTH PROMOTION PLAN

Get together with your team immediately after the first school visit. Share your experiences of your first school visit. Suggest realistic possibilities for any challenges you may have experienced. Refine the plan your health promotion project in the schools for the following 5 sessions.

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Reaction Paper 2: Due date 14 September 2017

Read the article – De Villiers et al. (2012). “HealthKick”: Formative assessment

of the health environment in low-resource primary schools in the Western Cape

Province of South Africa. Biomed Central Public Health, 12(1), 794-806.

Answer the following questions after you have read the article:

1. Discuss briefly the main issue that this study attempts to address. [10 marks]

2. Principals perceived an unhealthy diet, lack of physical activity, and being

underweight as the top three health priorities for learners (page 5). Why do

you think these three health priorities were found to be most prevalent

amongst learners in disadvantaged schools? [5 marks]

3. Explain the impact of the health barriers (table 5, page 6) on the health

priorities mentioned in question 2 above. [5 marks]

4. In your own words, write a brief response to the paper (200-250 words) [10

marks]

Total=30 marks

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SESSION 9: HEALTH PROMOTION Outcomes By the end of this session, you should:

1. Know the milestones in the history of health promotion. 2. Know the action areas of health promotion 3. Understand the development of health promotion in South Africa. 4. Understand the concept of health and its determinants.

Recommended readings: 1. http://www.who.int/healthpromotion/conferences/previous/ottawa/en/ 2. http://www.who.int/healthpromotion/conferences/previous/jakarta/declaration/en/index1.html 3. Hattingh, S., Dreyer, M., & Ross, S. (2006). Aspects of community health. (3rd ed.). Cape Town: Oxford

University Press. Pages 49-59. 4. Coulson, N., Goldstein, S. & Ntuli, A. (1998). Promoting Health in South Africa: An Action Manual.

Heinemann: Sandton. Chapter 6: pages 52- 72. 5. Hubley, J. & Copeman J. (2008) Practical Health Promotion. Polity Press, Cambridge, UK. Chapter 3

pages 61-82. 6. http://www.doh.gov.za/docs/policy/norms/part2d.html 7. Coulson, N., Goldstein, S. & Ntuli, A. (1998). Promoting Health in South Africa: An Action Manual.

Heinemann: Sandton. Chapter 12: pages, 147-157 8. Hubley, J. & Copeman J. (2008) Practical Health Promotion. Polity Press, Cambridge, UK. Chapter 3

pages 61-82. 9. http://www.doh.gov.za/docs/policy/norms/part2d.html 10. Coulson, N., Goldstein, S. & Ntuli, A. (1998). Promoting Health in South Africa: An Action Manual.

Heinemann: Sandton. Chapter 12: pages, 147-157

The history and recent developments of health promotion You will be introduced to the emergence of the health promotion movement, the Ottawa Charter and the subsequent Global Conferences on Health Promotion. Health Promotion Milestones

The 1st International Health Promotion Conference was held in Ottawa, Canada (1986) and produced the Ottawa Charter. The charter is considered one of the most important documents in health promotion and provides a framework under which health professionals can work.

The 2nd International Health Promotion Conference, Adelaide, Australia (1988)

focused on healthy public policy to strengthen the action areas listed in the Ottawa Charter.

The 3rd International Health Promotion Conference, Sundsvall, Sweden (1991),

called upon people to actively engage in creating supportive environments to promote health.

The 4th International Health Promotion Conference, Jakarta, Indonesia (1997)

where the Jakarta Declaration – into the 21st century was declared which focused on the importance of co-operation between all sectors of society including the private sector to address emerging threats to health. Here it was recognized that the settings approach is a practical way of implementing comprehensive strategies. The Jakarta declaration listed five priority areas for future development.

http://www.who.int/healthpromotion/conferences/previous/ottawa/en/

http://www.doh.gov.za/docs/policy/norms/part2d.html


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The 5th International Health Promotion Conference, Mexico City (2000) focused on

equity and inequities within and between countries, and future actions, particularly through health promotion.

The 6th Global HP Conference, Bangkok, Thailand (2005), which affirmed that

policies and partnerships to empower communities and to improve health and health equality, should be key to global and national development. It was recognised that the global context has changed markedly since the Ottawa Charter. The Bangkok Charter calls for strengthening of commitment from a wide range of stakeholders toward achieving health for all.

Even though these different conferences had different foci, they still built on or expanded on the Ottawa Charter. The Ottawa Charter is used globally as a framework for planning health promotion strategies and programmes. Health Promotion programmes are often not flagged or labeled as health promotion activities. Instead, they are often found embedded within the broad activities of health and development organisations. They are also found in a variety of different settings, and assume different approaches. First International Conference on Health Promotion Ottawa, 21 November 1986 – www.who.int/hpr/NPH/docs/ottawa_charter_hp.pdf The first International Conference on Health Promotion, meeting in Ottawa this 21st day of November 1986, hereby presents this CHARTER for action to achieve Health for All by the year 2000 and beyond. This conference was primarily a response to growing expectations for a new public health movement around the world. Discussions focused on the needs in industrialized countries, but took into account similar concerns in all other regions. It built on the progress made through the Declaration on Primary Health Care at Alma-Ata, the World Health Organization's Targets for Health for All document, and the recent debate at the World Health Assembly on intersectoral action for health. Definition of Health Promotion Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being (WHO, 1986). Prerequisites for Health The fundamental conditions and resources for health are: Peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice, and equity. Improvement in health requires a secure foundation in these basic prerequisites. Advocate Good health is a major resource for social, economic and personal development and an important dimension of quality of life. Political, economic, social, cultural, environmental, behavioural and biological factors can all favour health or be harmful to it. Health promotion action aims at making these conditions favourable through advocacy for health.

http://www.who.int/hpr/NPH/docs/ottawa_charter_hp.pdf

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Enable Health promotion focuses on achieving equity in health. Health promotion action aims at reducing differences in current health status and ensuring equal opportunities and resources to enable all people to achieve their fullest health potential. This includes a secure foundation in a supportive environment, access to information, life skills and opportunities for making healthy choices. People cannot achieve their fullest health potential unless they are able to take control of those things that determine their health. This must apply equally to women and men. Mediate The prerequisites and prospects for health cannot be ensured by the health sector alone. More importantly, health promotion demands coordinated action by all concerned: by governments, by health and other social and economic sectors, by non-governmental and voluntary organization, by local authorities, by industry and by the media. People in all walks of life are involved as individuals, families and communities. Professional and social groups and health personnel have a major responsibility to mediate between differing interests in society for the pursuit of health. Health promotion strategies and programmes should be adapted to the local needs and possibilities of individual countries and regions to take into account differing social, cultural and economic systems. Health Promotion Action Areas

1. Build Healthy Public Policy Health promotion goes beyond health care. It puts health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health. Health promotion policy combines diverse but complementary approaches including legislation, fiscal measures, taxation and organizational change. It is coordinated action that leads to health, income and social policies that foster greater equity. Joint action contributes to ensuring safer and healthier goods and services, healthier public services, and cleaner, more enjoyable environments. Health promotion policy requires the identification of obstacles to the adoption of healthy public policies in non-health sectors, and ways of removing them. The aim must be to make the healthier choice the easier choice for policy makers as well.

2. Create Supportive Environments Our societies are complex and interrelated. Health cannot be separated from other goals. The inextricable links between people and their environment constitutes the basis for a socio-ecological approach to health. The overall guiding principle for the world, nations, regions and communities alike, is the need to encourage reciprocal maintenance - to take care of each other, our communities and our natural environment. The conservation of natural resources throughout the world should be emphasized as a global responsibility. Changing patterns of life, work and leisure have a significant impact on health. Work and leisure should be a source of health for people. The way society organizes work should help create a healthy society. Health promotion generates living and working conditions that are safe, stimulating, satisfying and enjoyable. Systematic assessment of the health impact of a rapidly changing environment – particularly in areas of technology, work, energy production and urbanization - is essential and must be followed by action to ensure positive benefit to the health of the public. The protection of the natural and built environments and the conservation of natural resources must be addressed in any health promotion strategy.

3. Strengthen Community Actions Health promotion works through concrete and effective community action in setting priorities, making decisions, planning strategies and implementing them to achieve better health. At the heart of this process is the empowerment of communities - their ownership and control of their own endeavours and destinies. Community development draws on existing human and material resources in the community to enhance self-help and social support, and to develop flexible

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systems for strengthening public participation in and direction of health matters. This requires full and continuous access to information, learning opportunities for health, as well as funding support.

4. Develop Personal Skills Health promotion supports personal and social development through providing information, education for health, and enhancing life skills. By so doing, it increases the options available to people to exercise more control over their own health and over their environments, and to make choices conducive to health. Enabling people to learn, throughout life, to prepare them for all of its stages and to cope with chronic illness and injuries is essential. This has to be facilitated in school, home, work and community settings. Action is required through educational, professional, commercial and voluntary bodies, and within the institutions themselves.

5. Reorient Health Services The responsibility for health promotion in health services is shared among individuals, community groups, health professionals, health service institutions and governments. They must work together towards a health care system which contributes to the pursuit of health. The role of the health sector must move increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services. Health services need to embrace an expanded mandate which is sensitive and respects cultural needs. This mandate should support the needs of individuals and communities for a healthier life, and open channels between the health sector and broader social, political, economic and physical environmental components. Reorienting health services also requires stronger attention to health research as well as changes in professional education and training. This must lead to a change of attitude and organization of health services which refocuses on the total needs of the individual as a whole person. In the 1990’s, the Jakarta Declaration (WHO 1997) added five more action areas to the Ottawa Charter to further strengthen the work of health promotion. www.who.int/hpr/NPH/docs/jakarta_declaration_en.pdf

1. Promote social responsibility for health Decision-makers must be firmly committed to social responsibility. Both the public and private sectors should promote health by pursuing policies and practices that:

avoid harming the health of individuals protect the environment and ensure sustainable use of resources restrict production of and trade in inherently harmful goods and substances such as tobacco

and armaments, as well as discourage unhealthy marketing practices safeguard both the citizen in the marketplace and the individual in the workplace include equity-focused health impact assessments as an integral part of policy development.

2. Increase investments for health development to address health and social inequities

In many countries, current investment in health is inadequate and often ineffective. Increasing investment for health development requires a truly multisectoral approach including, for example, additional resources for education and housing as well as for the health sector.

Greater investment for health and reorientation of existing investments, both within and among countries, has the potential to achieve significant advances in human development, health and quality of life.

Investments for health should reflect the needs of particular groups such as women, children, older people, and indigenous, poor and marginalized populations.

http://www.who.int/hpr/NPH/docs/jakarta_declaration_en.pdf

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3. Consolidate and expand partnerships for health Health promotion requires partnerships for health and social development between the different sectors at all levels of governance and society. Existing partnerships need to be strengthened and the potential for new partnerships must be explored. Partnerships offer mutual benefit for health through the sharing of expertise, skills and resources. Each partnership must be transparent and accountable and be based on agreed ethical principles, mutual understanding and respect. WHO guidelines should be adhered to.

4. Increase community capacity and empower the individual Health promotion is carried out by and with people, not on or to people. It improves both the ability of individuals to take action, and the capacity of groups, organizations or communities to influence the determinants of health. Improving the capacity of communities for health promotion requires practical education, leadership training, and access to resources. Empowering individuals demands more consistent, reliable access to the decision-making process and the skills and knowledge essential to effect change. Both traditional communication and the new information media support this process. Social, cultural and spiritual resources need to be harnessed in innovative ways.

5. Secure an infrastructure for health promotion To secure an infrastructure for health promotion, new mechanisms for funding it locally, nationally and globally must be found. Incentives should be developed to influence the actions of governments, nongovernmental organizations, educational institutions and the private sector to make sure that resource mobilization for health promotion is maximized. "Settings for health" represent the organizational base of the infrastructure required for health promotion. New health challenges mean that new and diverse networks need to be created to achieve intersectoral collaboration. Such networks should provide mutual assistance within and among countries and facilitate exchange of information on which strategies have proved effective and in which settings. Training in and practice of local leadership skills should be encouraged in order to support health promotion activities. Documentation of experiences in health promotion through research and project reporting should be enhanced to improve planning, implementation and evaluation. All countries should develop the appropriate political, legal, educational, social and economic environments required to support health promotion.

Health Promotion in South Africa According to Onya (2007), health promotion first entered the South African health system in 1990. Currently, it is a directorate within the Social Sector Cluster (SSC), which in turn falls under Primary Health Care in the National Department of Health. There seems to be agreement that the first significant piece of health promotion policy appeared in the African National Congress (ANC) National Health Plan (ANC, 1994). The National Health Plan states that: “Health promotion combines diverse approaches such as legislation, fiscal measures such as taxation, controls on advertising, community action and development, intersectoral programmes, environmental monitoring and education” (ANC, 1994, p. 41). Health promotion service delivery seems to be the responsibility of the national, provincial and local governments, with provincial and local governments mainly implementing programmes with the support of the national government. The priorities for the national health system of South Africa for the period 2004-2009 were set to promote healthy lifestyles:

1. Initiate and maintain a healthy lifestyles campaign 2. Strengthen the health-promoting schools campaign 3. Initiate and maintain a diabetes movement 4. Develop and implement strategies to reduce chronic diseases of lifestyle, and 5. Implement activities and interventions to improve key family practices that impact on child

health.

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There is agreement, according to Hattingh et al. (2006) that the health promotion policy in South Africa should be built on the premise that health promotion is central to the success of primary health care, and that the role of health promotion should encompass:

1. Responsibility for community participation 2. Community and intersectoral development 3. Education 4. Mass media campaigns, and 5. Disease prevention

Based on this, it is apparent that health promotion requires the skills of an interprofessional team; this would include individuals from various sectors such as education, health, social development and the community. In addition, there are also national non-governmental organizations and community-based organizations which offer health promotion services across the country. These forums are non-institutionalized initiatives that aim to network, provide visibility, strengthen training opportunities, and promote advocacy work. This situation has resulted in fragmented health promotion services, with no single structure to coordinate activities. There is thus a need for a well-coordinated monitoring and evaluation of health promotion activities. The National Department of Health considered the settings approach as the key to the progress of health promotion in South Africa (Onya, 2007). The settings approach to health promotion takes into account all the elements of an environment and seeks to address those concerns which have an impact on health. The Health Promoting Schools (HPS) initiative is considered by the National Department of Health as one of its most successful programmes. Class discussion Refer to the diagram below. What do you think are the main issues that confront health promotion in South Africa today? Discuss with the person next to you and report back to plenary (5mins).

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SESSION 10: HEALTH PROMOTING SCHOOLS Outcomes At the end of this session you should:

1. Know the background of the health promoting school initiative. 2. Know the definition of a health promoting school. 3. Understand the health promoting school framework. 4. Understand the aims of a health promoting school.

Recommended readings: 2. Coulson, N., Goldstein, S. & Ntuli, A. (1998). Promoting Health in South Africa: An Action Manual.

Heinemann: Sandton. Chapter 1: pages, 1, 2 & 3 3. Du Plessis LM, Koornhof HE, Daniels LC, Sowden M & Adams R (2014). Health promoting schools as a

service learning platform for teaching health-promotion skills, African Journal of Health Professions Education, 6, 1, 48-51.

4. Refer to Glossary for definitions of health promoting schools on https://ikamva.uwc.ac.za 5. Onya, H. (2007). Health Promotion in South Africa. Promotion and Education, 14, (4), 233-237. 6. The Primary Health Care Package for School Health Services (2008) was developed by the Department

of Health. http://www.doh.gov.za/docs/policy/norms/part2d.html 7. The Care and Support for Teaching Learning (CSTL) Programme.

http://www.education.gov.za/Programmes/HealthPromotion/CSTLProgramme

Health Promoting Settings: The settings approach focuses on the local level. It is based on a place or social grouping, rather than an illness or symptom. It is more than ‘health education in a setting’ because it involves a comprehensive and coordinated approach. Some examples of settings include: Universities, neighbourhoods, workplaces, hospitals, communities, markets, prisons, islands, schools, cities/towns. Within the settings approach there is always the major commitment to:

• equity

• empowerment

• multi-disciplinary participation

• multi-sectoral participation Health Promotion settings are based on the importance of a collaborative approach that involves intersectoral collaboration and community participation. They recognize the importance of environmental and structural aspects over behaviour and recognize the importance of organisational and community development for change. Let us look at the school as a Health Promoting setting and see how the action areas of the Ottawa Charter can be put into practice within that setting. For the purposes of this module, the primary schools will be the Health Promotion setting.

What is a health promoting school?

Vision Optimal health and development of school–going children and the communities in which they live and learn.



http://www.education.gov.za/Programmes/HealthPromotion/CSTLProgramme

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Goal To provide a policy for the development of a comprehensive school health service that operates within the framework of the Health Promoting Schools Initiative. This service will respond equitably to the varying health and development needs of learners, within the parameters of the national health system. A health promoting school is a place where all members of the school community work together to provide students with integrated and positive experiences and structures that promote and protect their health. This includes both the formal and informal curricula in health, the creation of a safe and healthy school environment, the provision of appropriate health services and the involvement of the family and wider community in efforts to promote health (World Health Organisation, 1996)

What are the advantages of a health promoting school?

The health promoting school:

• offers a holistic model of health that includes the interrelationships between the physical, mental, social and environmental aspects of health;

• provides the opportunity for families to take part in the development of health skills and knowledge of their children;

• addresses the significance of the physical environment (for example, shaded play areas) in contributing to the health of children;

• recognizes the importance of the social ethos of the school in supporting a positive learning environment, one in which healthy relationships and the emotional well-being of students are strengthened;

• links regional and local health services with the school to address specific health concerns that affect school children;

• focuses on active student participation in the formal curriculum to develop a range of life-long health-related skills and knowledge;

• enhances equity in education and health.

• provides a positive and supportive working environment for school staff; and

• enables the school and the local community to collaborate in health initiatives that benefit students, their families and community members.

(World Health Organisation, 1996)

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The Health Promoting Schools Initiative (HPS) is an internationally accepted programme that has recently been established in South Africa. It is underpinned by a health promotion philosophy and has five components that together provide the basis for school health. See the illustration below.

Health Promoting School Initiative

1. Develop healthy school policies that will assist the

school community in constantly addressing its health

needs.

5. Access to appropriate

services to address the health

needs of the school community

Health

Promoting

Schools

2. The development of the

school as a supportive

environment for the

development of health

attitudes and practices.

4. The development of personal skills of

members of the school community, thus

enabling them to improve their own health and

influence the healthy development of others.

3. Community action that involves the

school and broader community in taking

ownership of and seeking ways to address

their collective health needs by accessing

resources for health.

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Health Promoting Schools Model

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Task 1 In pairs briefly refer to the above and complete the following: Task 2 Can you see the similarities between this framework and the action areas of health promotion? Discuss it with the person sitting next to you.

A health promoting school can be characterised as…

A health promoting school aims to…

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Task 3 Think of the primary or secondary school you attended and answer the following questions individually, then discuss it with the person next to you or group. Refer to the policy documents discussed earlier in the course, at all times. Report to plenary.

1. How would you develop an organisational culture that promotes a safe, healthy and stimulating learning and working environment for students and teachers at your previous school?

2. How would you go about identifying the school community’s specific health needs and establish their own priorities so that they can focus on relevant health issues in their school.

3. What strategies would you use that will enable you to collaborate with parents and students on problem solving, decision making and action in relation to health issues in the school community. Give some practical examples.

4. Describe the process that will involve the implementation of a holistic, coordinated and action-oriented approach to health promotion and education in the school.

5. How would you go about establishing effective partnerships with other health services, agencies to develop, implement and monitor health promotion programs, service provision at your school and who do you think should be the partners?

Self-Study 1. In preparation for the next session, research the following health promotion approaches.

• Medical or Preventive • Behaviour Change • Educational • Empowerment

• Social Change

Reaction Paper 3: Due date 26 October 2017

Read the article. RETHINKING HEALTH PROMOTION AND DISEASE PREVENTION IN AFRICA: THE QUEST FOR AN INTEGRATED MODEL. By Adnemaríam Kidanemariam, Journal of Third World Studies, Vol. XXVIIl, No. 2, 2011. Answer the following questions after you have read the article:

1. Discuss briefly the problem that this study attempts to address. (5 marks)

2. Explain briefly the three theoretical models of health promotion: (i) bio-medical

model, (ii) life-style change model and iii) political economy model in terms of its

theoretical and ideological underpinnings and strengths and weakness. (9 marks)

3. Discuss briefly the main argument of the author? Refer to the author’s proposed

integrated model of disease prevention and health promotion. (10 marks)

4. In your own words, write a brief response to the paper (200-250 words). (6

marks)

Total = 30 marks

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SESSION 11: HEALTH PROMOTION APPROACHES & INTERVENTIONS & COMMUNICATION Outcomes At the end of this session you should:

1. Know the different approaches and models to health promotion. 2. Introduced to the importance of communication in health promotion.

Task 1 Briefly describe and explain the following 5 approaches to the person sitting next to you or in a group. Please write down your discussion. Share your thoughts in plenary. The five health promotion approaches:

• Medical or Preventive • Behaviour Change • Educational • Empowerment • Social Change

Approaches and models to health promotion According to Keleher (2007) health promotion approaches range from those grounded in a primary care paradigm such as health counseling and health education towards community-based practice such as capacity-building for health promotion including organizational change, community development, and policy. However, very few health promotion practitioners are skilled across the range of practices and tend to focus on achieving individual behaviour change. Keleher (2007) argues that the health promotion principles and action areas suggest that those approaches indicating single level (i.e. working with individuals), single sector(i.e. health), single action approaches (i.e. behaviour change) to health promotion are unlikely to have much effect. Therefore, for health promotion to have a greater impact there is a need to use an integration of approaches and to work across sectors. Why do we need to understand health promotion approaches and models? Models and approaches are ways of explaining complex situations and suggest the appropriate approach and action to take. Health promotion approaches guide us in obtaining the kinds of information we need to obtain from our communities or target groups, for example about beliefs, norms, cultural factors; at whom to direct our health promotion efforts; what kind of messages to promote; who to network with and at what level we need to work. The right choice of the model helps us to design health promotion activities that are effective and sustainable. Table 1, below summarizes the health promotion approaches (Keleher 2007). It outlines the health approach; the associated theory or model that it is based on; the aims of the approach; the methods used and the level and type of action. Table 1: Summary of Health Promotion Approaches (Keleher, 2007)

APPROACH THEORY/MODEL AIMS METHODS LEVEL & TYPE OF ACTION

Primary care/ Disease prevention

*Biomedical Treatment & diagnosis; Prevention & management of conditions

Improve physiological risk factors (e.g. high blood pressure, early detection, immunization) and personal

*Takes advantage of a person’s point of entry to health system through GP, nurse or allied health professional

*Individuals *Expert-led *Passive client

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behaviours *Screening *Advice

Health education & behaviour change

Behaviour change theories: *Reasoned Action; *Health Belief; *Health Action; *Stages of Change

Psychosocial & behavioural risk factors (e.g. smoking, poor nutrition, physical inactivity)

*Health information *One–to-one or group education sessions *Development of personal skills

*Individuals or groups *Expert-led *Passive clients

Participatory health education

*Participation *Empowerment

Provision of information e.g. : *Healthy choices *Social support *Development of personal skills via empowerment

Integrated methods *Health development *One-to-one or group education sessions *Social marketing *Settings approach

*Individuals or groups *Active clients *Facilitation

Community action

*Community development *Community engagement

*Action on determinants of health *Sustainable social change *Strengthening community capacity *Empowerment

*Intersectoral partnerships and collaborations *Community capacity-building *Building social capital *Community control *Policy and organizational change *Enabling *Advocacy *Mediating

*Intersectoral partnerships and collaborations *Community action *Community leadership *Organizational change

Socio-ecological health promotion

*Determinants of health *Health and social development *Primary health care *Empowerment *Community engagement

*Redress of inequities *Works from health determinants: social, political, environment.

*Primary health care *Community engagement *Creating supportive environments *Advocacy *Enabling *Mediating *Organizational development to re-orient health services *Build healthy local policy

*Active clients and communities * Changes in communities and organizations

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Health promotion interventions It is thought that the landscape of health promotion is moving upstream because downstream approaches have done little to change the health status of the poorest and most vulnerable people. The focus of health promotion is therefore on practices that will create social change and address inequities so that people and communities have opportunities to develop skills required for good sustainable health and empowerment.

Downstream Interventions Upstream

Primary Care Approaches Life-style /Behaviourist Approaches

Socio-ecological Approaches

Interventions

Strategic communication in health promotion Your lecturer will introduce you to the importance of effective communication in health promotion. This section explores the communication skills and strategies that underpin health promotion activities. Communication is integral to all health promotion activities. It can identify community needs. It can bring decision-makers’ attention to these needs or other health issues that need to be addressed. It is through communication that health promotion can be delivered either face to face between a health worker and a client, a presentation to decision makers, a mass meeting of communities, or through a variety of media. The following strategic key issues needs to be considered for effective communication in health promotion:

WHAT is the message? WHO should the message be delivered to? WHO should be the messenger? WHEN should the message be delivered? WHY?

The importance of communication in health promotion is portrayed in the following case study of a recent health professional graduate. (Excerpt taken from Murphy, B. (2007). Strategic Communication in Understanding Health Promotion. Chapter 11 p156.)

There I am standing by the shore of a swiftly flowing river and I hear the cry of a

drowning man. So I jump into the river, put my arms around him, pull him to shore

and apply artificial respiration. Just when he begins to breathe, there is another

cry for help. So I jump into the river, reach him, pull him to shore and apply

artificial respiration, and just as he begins to breathe, there is another cry for

help. So back in the river again, reaching, pulling, applying, breathing and then

another yell. Again and again, without end, goes the sequence. You know, I am so

busy jumping in, pulling them to shore applying artificial respiration, that I have no

time to see who is upstream pushing them all in… (Mc Kinlay 1974:9)

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Communication skills in day-to-day health promotion: Experiences of a new graduate When I left university, I had a strong theoretical understanding of health promotion frameworks and models, underpinned by knowledge of the determinants of health. I felt very well prepared to contribute to program planning, evaluation, and policy development. Since graduating, I have been working in a rural community with a population of 2000 people spread over a huge geographical area. I have found that while the theoretical provides scaffolding for the work that I do, my day-to-day activities are all about creating networks, building partnerships, mediating between stakeholders, and engaging groups in the community. I negotiate with other sectors such as sport, recreation, education, local government, and transport to link them into a health agenda. At university we were taught about the importance of partnerships and collaboration. I wish I had been taught more about how to engage community members and other stakeholders, how to contact them, how to persuade them, how to link them together, how to lobby, how to work with them to access and utilize resources. Creating systems and structures for effective, evidence-based health promotion action means considering different ways of working…. It means building relationships, being inclusive and respectful, building trust, establishing guidelines for operating. I need a range of communication skills to be at ease in all of these situations. And I need to use these skills effectively if I am going to make a difference. Strategies to address a local health priority might typically be conceptualized at a formal Primary Care Partnership meeting, but it can also be sparked by an informal chat with key stakeholders at the local netball or football game. Opportunistic and informal approaches are quite important in small communities like mine. I could sit in my office and write a brilliant health promotion program plan for this community but in the end nothing much would change. In truth the real work happens when I walk out of the office door and start talking to people.

1. Having read the case excerpt above, discuss with the person next to you what you think are the core knowledge & skills that a health promotion professional should have.

Impact of media on health Media as a means of communication provides knowledge and raises awareness of health problems thereby contributing to knowledge, behaviour and attitude change. Skills can be demonstrated through the media. Media can role model positive behaviour. Media can link people to resources, e.g. through advertising. It can also generate public support for policy initiatives which can influence decision makers to take appropriate actions, e.g. documentary programmes such as Special Assignment. A defining feature of the media is that it can reach large numbers of people quickly. Discuss with the person next to you: The various means of media that you know of and the impact of mass media on individuals and communities, give concrete examples. Report to plenary.

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SESSION 12: POSTER AND GROUP REPORT PREPARATION Outcomes By the end of this session, you should: 1. Have developed an understanding of the steps required to make a poster

AMEE

Information for Poster Presenters The following suggestions and recommendations have been compiled based on published literature and by reference to

various websites. They are not intended to be prescriptive, and we welcome ingenuity and something a little different.

General

A successful poster provides just enough information to convey the key point(s) clearly and succinctly. It is important to

get the message across quickly – you may only have a short time to capture the viewer’s attention. Too much information

on a poster causes confusion and will be time-consuming to read. It may be better to focus on one key point, unless

subsidiary points are essential to its understanding. Those sufficiently interested can always request further information via

the contact details given, or discuss the work at the poster session.

The poster should be attractively laid out, and logically sequenced, with visual representation preferable to large chunks of

text. Thinking of a poster as an “illustrated abstract” (Hess and Liegel, 2004) may help. Careful use of colour and size of

text is important.

Question and answer type posters work well, and interactive posters are frequently attractive to participants.

Content Guidelines Posters may report research results, or may be descriptive, eg, presenting a theory, or a new curriculum/course or teaching

method.

Research posters: The following components are usually included:

Introduction and identification of need;

Objective(s), purpose(s), research questions(s);

Methodology (sample, methods for data collection and evaluation): It is more important to communicate the results

and conclusions than to go into detail about the methods. If participants show a particular interest in the methodology

they can always request further details to be sent, eg a copy of a questionnaire used in the study;

Data analysis;

Results/Discussion: It may be appropriate to report only some of the more important results, in the interests of space.

Complex argument is not appropriate for a poster. Tables and figures are a good way of communicating results rather

than blocks of text as they are frequently easier to understand, visually more attractive and less space-consuming.

Conclusion(s)/Take home message(s): It is recommended that only conclusions clearly supported by the results are

displayed on the poster, and more speculative conclusions should not be included.

Descriptive posters: The content and structure of descriptive posters are more flexible and will largely be decided by the

purpose of the poster. It is suggested however that the following aspects should be considered in relation to content:

Introduction to the topic/identification of need;

Objectives/purposes of the work;

Description of what was done;

Discussion of what was achieved and how the work has advanced understanding of the topic;

Conclusions/take-home messages.

Style Guidelines

Layout:

The title of the poster, name(s) of authors, address where the work was carried out and contact details should be

prominently displayed;

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It is not necessary to cover the whole poster with information – use of ‘white space’ provides a pleasing contrast,

particularly where a large amount of colour is used on the poster;

“Reader gravity” – the natural way in which the reader’s eye is drawn to look at the poster, suggests that

information should be laid out either from top to bottom, or left to right;

Small blocks of text of up to 75 words are recommended, and use of appropriate level of headings makes the

poster easier to read;

Bulleted lists are an alternative to blocks of text in some instances;

Visual representation is preferable to text wherever possible. Diagrams, tables, photographs, arrows etc can aid

readability and add to the attractiveness.

Font and colour:

Sans serif fonts such as Arial or Helvetica are generally considered to aid legibility for posters. At least 20 point is

recommended for text and at least 72 point for the title. Font should be consistent throughout the poster, and

appropriate levels of headings should be used;

Judicious use of colour is recommended, with a maximum of two or three primary colours (eg, red, blue, green or

yellow) introduced (however some shades of yellow may be difficult to read). Black type on a white background is

standard practice, and patterned backgrounds should be used with care.

Figures and graphics:

Figures and graphics should be of good quality and should be appropriately labelled with short legends;

Graphs and charts should have an appropriate scale and labelled axes.

Additional information not on the poster:

It is helpful if presenters can have the following additional information available by the poster board:

Printouts of their posters or handouts of the key points, and contact details, for participants to take away. Around

50-75 copies would be appropriate;

A note on their poster board of the time(s) they will be available by the board for those who would like to discuss

the poster outside the formal presentation time.

Bibliography Nicol A A M and Pexman P M (2003). Displaying Your Findings: a practical guide for creating figures, posters and

presentations. Washington DC: American Psychological Association

Hess G and Liegel L (2004) Creating Effective Poster Presentations. http://www.ncsu.edu/project/posters (accessed 02 June

2004) Please consult the the website is https://ikamva.uwc.ac.za on how to design your poster using PowerPoint XP. Poster Specifications: Size: Minimum size is A1 (The A1 size print measures 594mm X 840mm). Notices for printing companies & costs will be communicated to you via ikamva.

Session 13: Presentations & Course Evaluation

THANK YOU For submitting your group report, critical incident reflective journal and completing the course

evaluation. Good Luck for the examination!

http://www.ncsu.edu/project/posters


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