‘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.

Improving primary school health education through action research : a case study

Limited research has been conducted concerning the actual practice of health education in Victorian schools. This study investigates the health education curriculum at a large primary school in the south-eastern suburbs of Melbourne. The investigation involves a critical analysis of current practices in health education in the upper school through the development of a ‘small’ action research group. Data were gathered through document collection, questionnaires, interviews, discussions, diary and reflective journal entries. The action research group, consisting of the teacher-researcher and upper school teachers, developed, implemented and reflected upon units of work piloted with upper school students. Alternative approaches to health education were explored. The aim was to accommodate critically informed discourse amongst colleagues to promote self-reflective enquiry and facilitate improvements to existing pedagogic practices. During the course of the investigation, factors limiting and facilitating action research and curriculum change in health education, became evident. These included personal, practical, curriculum and organisational constraints operating externally and internally on the school and classroom environments. Despite these constraints, it was demonstrated in this study, that action research can contribute to the improvement of pedagogic practices in health education. Small ‘authentic’ action research projects may provide alternative internal professional development structures for teachers and consequently improve learning opportunities for students.

Adaptation and validation of the Japanese version of the health education impact questionnaire (heiQ-J) for the evaluation of self-management education interventions

Aim: