WHAT CAN A HEALTH EDUCATOR DO FOR YOU?

by Alice Sariyildiz

Pick up any literature on self-management of diabetes and you are likely to find a list of professionals who are a part of your health care team. Your physician, endocrinologist, nurse, and dietitian are all mentioned. Sometimes a social worker will be included. However, two notable omissions are of clergy and health educators, and both of these professionals can be vital to your quality of life.

What is the background of a health educator?

Ideally, health educators have an advanced degree at the time they enter the profession. Those candidates seeking certification will have prepared at accredited universities, doing undergraduate and graduate work in health education, often with an emphasis in public health. After successfully completing written examination and review, health educators are licensed for 5 years, during which time they are required to complete 75 hours of continuing education. The National Commission on Health Education Credentialing (NCHEC) in Allentown, Pennsylvania, regulates entry into the profession, and award of the designation CHES, Certified Health Education Specialist.

Health Educators are assigned a certification number upon successful completion of a standardized test that measures seven designated areas of responsibility. The seven competencies are as follows: The assessing of individual and community needs for health education; the planning of effective health education programs; the implementing of health education programs; evaluating the effectiveness of health education programs; coordinating provision of health education services; acting as a resource person in health education; and communicating health and health education needs, concerns and resources.

The test is administered only to health educators who make successful application to the NCHEC. Their résumé must include graduation from an accredited university (graduate school preferred), with a specific minimum number of hours of course work in health education.

How are health educators prepared to teach health promotion and improvement in the quality of life?

While clinicians typically study the human body from a medical/treatment perspective, health educators learn about all of the influences that combine to create the whole person. They do not hold to a theory of one germ-one disease, but rather that heredity, environment and lifestyle all impact on the effects of one or several invaders. They come from the perspective that health problems are best prevented, rather than fixed after-the-fact.

Health education is a multi-disciplinary study. From anthropology, they study cultural diversity and environmental influences on health behaviors. From nursing, they consider the physical and emotional aspects of care. From ethics, they study how interventions must not be imposed upon people but rather desired by them. From social work, they learn about behavior theory and individual assessment. From medicine they analyze scientific research and translate it into practice. From business, they incorporate (pun intended!) organizational principles and outcomes orientation. They look for the biggest bang for the buck--the most efficient use of a wide range of resources. They don't have all the answers, but many answers can be found directly from the people they serve.

What can a health educator do for you?

I have been a health educator for two years now. I work for the Florida Department of Health, where we are proud to have a Health Education Division that includes nine team members.

In our local health department, we serve a diverse county of farm workers and retirees, of low-income families and other citizens and visitors. We work in partnership with hospitals, schools, The Lighthouse, and various community agencies in our efforts to protect the public's health. One of our most successful programs is a series of diabetes management classes provided under the American Diabetes Association guidelines. These classes are free, thanks to a block grant from the Federal government through the Centers for Disease Control.

As the Health Educator, I promote, organize, and teach a portion of the classes, while the Public Health Nutritionist and a Registered Pharmacist teach other specialized units of the curriculum. We served perhaps 100 people last year. Besides an average increase in knowledge of 30 points from pre- to post-test, some of our students achieved weight loss, tobacco cessation, and lower HbA1C results.

But the true test of our success is in the improved quality of life that came about from our intervention, voiced in comments such as these made on the class evaluations: "I learned more here than at my MD," "Just wish this wasn't the last class... Please start a support group so we can continue to meet with you." (And we did).

As health educators we don't just supply information. We study the needs of specific populations and target our health messages using specific behavior theories developed for health education. We create a supportive and caring environment where our students learn the skills they need to manage their health, and the confidence to do it. They learn to use all the members of their health team to their fullest advantage, including their health educators, to help prevent blindness and other complications of diabetes before they begin.

At present, because of time and economic constraints, physicians are not always able to provide education to their patients. However, most do recommend their patients with diabetes get additional education at least once a year. If you are fortunate enough to have your physician recommend that you go, please take his or her advice and learn all you can about preventing complications from diabetes and other chronic conditions that you may have. If you think you receive enough education at your doctor's office, then ask yourself these questions: Does my physician have sufficient knowledge and skills in the seven competencies? Does a nurse or someone else in the physician's office perform education according to these standards? Or, should I be looking elsewhere for these services?

If you'd like to learn more about health educators, contact the Society for Public Health Educators (SOPHE) at http://www.sophe.org or call (202) 408-9804, in Washington, D.C. You can also contact your local health department or a school of public health in your area. Here's wishing you success in a lifetime of learning and personal empowerment!