Workshop synopses : Pathways for public health education

The Commonwealth introduced the Public Health Education and Research Program (PHERP) initiative to support capacity building within the public health workforce, primarily through investment in Master of Public Health programs. Following the 2005 review of PHERP, a national 'Quality Agenda' was proposed to establish minimum standards in public health competencies of graduates; and Master of Public Health (MPH) graduates in particular. This 'agenda' has triggered renewed discussion on public health workforce needs, public health graduate competencies, and the capacity of the tertiary education sector to deliver these.

The Australian Network of Academic Public Health Institutions (ANAPHI) has worked with the Department of Health and Ageing on the 'Quality Agenda'. In 2008, ANAPHI convened a working group to further open up discussion among academic institutions on the public health education context to the Quality Agenda. The group held a lunchtime workshop at the 2008 Population Health Congress in Brisbane, as one of a themed pair of sessions entitled 'Public Health Professionals - Shaping our Future'. A further aim of the workshop was to identify key themes to shape the next ANAPHI Teaching and Learning Forum (September 23rd to 24th 2008, Canberra, www.anaphi.org.au).

Measurement of stable changes of self-management skills after rehabilitation: a latent state-trait analysis of the Health Education Impact Questionnaire (heiQ™)

To assess stable effects of self-management programs, measurement instruments should primarily capture the attributes of interest, for example, the self-management skills of the measured persons. However, measurements of psychological constructs are always influenced by both aspects of the situation (states) and aspects of the person (traits). This study tests whether the Health Education Impact Questionnaire (heiQ™), an instrument assessing a wide range of proximal outcomes of self-management programs, is primarily influenced by person factors instead of situational factors. Furthermore, measurement invariance over time, changes in traits and predictors of change for each heiQ™ scale were examined.

Health-related empowerment in cancer: validity of scales from the health education impact questionnaire

Empowerment refers to an individual's feelings of being able to manage the challenges of the cancer experience and of having a sense of control over one's life. However, empowerment questionnaires that have been validated for the cancer setting are lacking. The objective of this study was to validate scales from the Health Education Impact Questionnaire (heiQ), which assesses the effects of health education programs among individuals with chronic conditions. The heiQ scales Social integration and support, Health service navigation, Constructive attitudes and approaches, Skill and technique acquisition, and Emotional distress were identified as key dimensions of empowerment for the cancer context.

Measurement invariance across chronic conditions: a systematic review and an empirical investigation of the Health Education Impact Questionnaire (heiQ™).

To examine whether lack of measurement invariance (MI) influences mean comparisons among different disease groups, this paper provides (1) a systematic review of MI in generic constructs across chronic conditions and (2) an empirical analysis of MI in the Health Education Impact Questionnaire (heiQ™).

Does the poor quality of Australian health education documentation undermine the message? A review of documents informing pregnant women about alcohol

Background. The advice given to pregnant women about alcohol consumption during pregnancy is variable across countries and within countries.Aim. The aim of this study was to review the content and design of existing Australian health education documentation regarding alcohol consumption in pregnancy that is available to pregnant women. Methods. A documentary analysis was conducted. This involved the identification and collection of a range of health education documents, which were then systematically analysed. The thematic and symbolic elements of each document were compared and contrasted using a modified version of the DISCERN instrument. Findings. A total of 32 documents were retrieved via general and targeted internet searching. Documents varied considerably in their purpose, language levels, accessibility, and quality. The majority of documents scored as low to moderate quality. Implications. Although there are many and varied existing documents relating to alcohol consumption during pregnancy in Australia, these are not of high quality and could be substantially improved by including publication dates, using simple language, and providing sources of information. This may result in a more effective public health message and so help to reduce the number of pregnant women who continue to drink during pregnancy.

Health promotion and health education in schools : trends, effectiveness and possibilities

This report involved an extensive literature review as well as discussions with ten leading school health and traffic safety education researchers and practitioners. The findings of the report show that despite health promotion and health education activities occurring in all Victorian schools, school health related initiatives could be improved by focusing on cognitive outcomes and involving appropriate components of Health Promoting School (HPS) framework. Providing teachers with professional development and utilising interactive resources that complement the curriculum is also important. The report recommendations outline ways to improve the Health Promotion and Health Education and provide a potential framework for delivering TSE provision in schools.

Pursuing HPE outcomes through health education

This chapter provides an analysis of how the contemporary curriculum operates in relation to pursuing Health and Physical Education (HPE) outcomes within health education and some of the intended and unintended consequences of such an approach

Risky business: health education and the limits of risk discourse

The paper explores the ways in which risk operates as a powerful discourse that shapes what health education teachers said about and what they did in their classroom practices. The paper draws on a qualitative study that seeks to explore the dominant and contesting discourses within health education.

‘Be yourself and have a ball’ : using a school and community based health education model to build young women’s resilience and connectedness

Recognition of the important role schools play in the promotion of student wellbeing can be seen in the growing number of polices and programs being implemented in schools across the Australia. This paper reports on some initial data from focus group interviews with year 9 and 10 girls involved in the pilot of a health and physical activity intervention designed to connect them to their local community and reconnect them with their school and their peers. The aim of the program was to build connectedness and resilience by engaging young women in non-traditional physical activities whilst providing them with a sound understanding of health issues relevant to adolescent girls. Situated in a relatively isolated rural community 200 kilometers south east of Melbourne the program was overwhelmingly delivered by regional and local agencies in conjunction with the local secondary school. The intervention was built on a partnerships model designed with the purpose of increasing participation and access for young women whilst building a sustainable program run in partnership between the school and local agencies and services. The initial data from this pilot indicates the program is having a positive impact on the young women’s sense of self and their bodies, their relationships with their peers and in reducing bullying behaviour amongst the girls. However the data raises some important questions around the adequacy of school-based health education, and the sustainability of approaches designed to be delivered by outside agencies rather than classroom teachers.

The Health Education Impact Questionnaire (heiQ): An outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions

Objective: This paper describes the development and validation of the Health Education Impact Questionnaire (heiQ). The aim was to develop a user-friendly, relevant, and psychometrically sound instrument for the comprehensive evaluation of patient education programs, which can be applied across a broad range of chronic conditions.

Methods: Item development for the heiQ was guided by a Program Logic Model, Concept Mapping, interviews with stakeholders and psychometric analyses. Construction (N = 591) and confirmatory (N = 598) samples were drawn from consumers of patient education programs and hospital outpatients. The properties of the heiQ were investigated using item response theory and structural equation modeling.

Results: Over 90 candidate items were generated, with 42 items selected for inclusion in the final scale. Eight independent dimensions were derived: Positive and Active Engagement in Life (five items, Cronbach's alpha (α) = 0.86); Health Directed Behavior (four items, α = 0.80); Skill and Technique Acquisition (five items, α = 0.81); Constructive Attitudes and Approaches (five items, α = 0.81); Self-Monitoring and Insight (seven items, α = 0.70); Health Service Navigation (five items, α = 0.82); Social Integration and Support (five items, α = 0.86); and Emotional Wellbeing (six items, α = 0.89).

Conclusion:The heiQ has high construct validity and is a reliable measure of a broad range of patient education program benefits.

Practice Implications: The heiQ will provide valuable information to clinicians, researchers, policymakers and other stakeholders about the value of patient education programs in chronic disease management.

Comparison of the pre-post and transition question assessments in a health education setting

Objective : This study examined the classical pre-intervention/post-intervention assessment (pre–post) and the single post-intervention transition question assessment (transition question) to determine how well these methods reflected qualitative interview–based participant-reported outcomes from chronic disease self-management education programs (CDSMEPs).

Study Design and Setting : A mixed-method qualitative and quantitative approach was applied in 25 interviews with participants recruited from CDSMEPs within Australia. Qualitative interviews with participants were used as a relative “gold standard” and compared with questionnaire-based pre–post and transition question assessments.

Results : Comparison of the two questionnaire-based assessments showed that most of the individual paired responses were discordant (61%). Using participant's qualitative narratives as a “true” indicator, the pre–post assessment was found on more occasions to be discordant with participant-reported outcomes than the transition question. The origin of the inconsistency was largely because of a change in respondents' perspective that had occurred after pretest, which was mediated by CDSMEPs' experiences and insights.

Conclusion : This study suggests that the pre–post assessment has poor validity for the assessment of health education program outcomes. Alternative assessments, such as the transition question, may result in a more accurate reflection of the impact of such programs on participants.