The Health Education Profession in the Twenty-First Century · Twenty-First Century Progress Report...

The Health EducationProfession in the

Twenty-First Century

Progress Report1995 – 2001

Association of State andTerritorial Directors of HealthPromotion and Public HealthEducation

Coalition of National HealthEducation Organizations

National Commission for HealthEducation Credentialing, Inc.

Eta Sigma Gamma

Public Health Education & HealthPromotion Section—AmericanPublic Health Association

School Health Education &Services Section—AmericanPublic Health Association

Society for Public HealthEducation, Inc.

Society of State Directors ofHealth, Physical Educationand Recreation

Progress Report1995 – 2001

The Health EducationProfession in the

Twenty-First Century

Copyright © 2001 Coalition of National Health Education Organizations (CNHEO)Printed in the United States of America.

The compositor for this document was Pat McCarney.

Design and production of this book was donated by Comprehensive HealthEducation Foundation (C.H.E.F.®).

TABLE OF CONTENTS

Preface

Overview ............................................................................. 1

Work Between 1995 and 2000 ..................................... 2Internal/External Actions ............................................ 2Communication with Members of the Profession .......... 3Organization of the Report ........................................... 3

Focal Point Summaries........................................................ 5

Professional Preparation .............................................. 5

Definition............................................................. 5Introduction......................................................... 5Internal Actions/Goals ......................................... 5External Actions/Goals ........................................ 12Future Actions ..................................................... 13

Quality Assurance ....................................................... 14


Research ..................................................................... 21


Advocacy ..................................................................... 25


Promoting the Profession ............................................. 31

Definition............................................................. 31Introduction......................................................... 31Internal Actions/Goals......................................... 31External Actions/Goals ........................................ 34Future Actions ..................................................... 36

Dynamic/Contemporary Practice ................................. 38

Definition............................................................. 38Introduction......................................................... 38Internal Actions/Goals......................................... 38External Actions/Goals ........................................ 39Future Actions ..................................................... 41

Conclusions and Recommendations .................................... 43

Afterword ............................................................................ 49

Executive Summary ............................................................ 51

References........................................................................... 53

Appendix A: Organizations Participating in the HealthEducation Profession in the Twenty-FirstCentury Project ............................................... 57

Appendix B: Names of All Individuals Who Participated ...... 63

Appendix C: Organization Contributions and Progress TowardMeeting The 21st Century Recommendations ... 67

Appendix D: Matrices ......................................................... 99

NOTE:Page numbers are not accurate in this PDF.No appendices have been included here.

Outstanding accomplishments in advancing the health of the public are frequently cel-ebrated as we enter the new century. One hundred years ago, no one could have forecastthe possibility of organ transplants or the eradication of fearful infectious diseases suchas smallpox or polio. As exciting as these accomplishments are, however, we know thatmany challenges still remain to be addressed, such as the existing racial and ethnicdisparities in health status, emerging or reemerging pathogens, the adoption of healthylifestyles, and the potential applications of the Human Genome Project.

For those of us in the health education profession, critical achievements during the pastcentury for the profession were the accreditation of schools and programs offering degreeswith a concentration in health education and the establishment of a credentialing systemfor health educators. Dr. Helen Cleary has provided a chronology of the comprehensiveeffort that was required by our professional organizations to develop a consensus for theframework that now describes the entry-level competencies in health education for theprofession. This framework provides critical guidance for institutions preparing healtheducators as well as for the credentialing process of individuals. Without a continuationof the joint effort of all health education professional organizations for quality assurance,however, the maturation of the health education profession in this new century will not bepossible.

With the subsequent birth of a certification process for health education specialists at theclose of the 20th century, it is now critical for the health education profession to continueits joint work as together we address the next implementation challenges. Just as theaccomplishments of the past century provide the foundation for the next level of publichealth achievements, the foundation for the entry-level practitioner has been establishedfor us to move forward with the credentialing process and to assure that our academicinstitutions training the next generation of health educators seek the appropriate accredi-tation. As a profession, it is up to each one of us to ensure that entry-level competenciesare recognized, translated into curricular requirements for accreditation, and serve as thefoundation for the continued development and validation of advanced-level competencies.

The following report provides the foundation for our next steps as we enter the 21st cen-tury. Critical recommendations have been identified by a working group that includesrepresentation from our health education professional organizations, accrediting bodies,and academic institutions. While it includes the philosophy and vision for our futuredirections, it will take the commitment of each one of us to be sure that the recommenda-tions are translated into action. This is an exciting time to be actively involved in thepractice and profession of health education. With a renewed commitment by each one ofus, the future directions for quality assurance in the practice and profession of healtheducation will be realized.

Audrey R. Gotsch, DrPH, CHESInterim Dean, UMDNJ–School of Public HealthPast President, APHAPast President, Council on Education for Public Health

PREFACE

In June 1995, the National Commission forHealth Education Credentialing, Inc., andthe Coalition of National Health EducationOrganizations, USA, convened a forum inAtlanta, Georgia, to consider the future ofthe health education profession (The HealthEducation Profession in the Twenty-FirstCentury: Setting the Stage, Journal ofHealth Education, 27(6), 357-364, 1996).Twenty-four participants represented 10national professional organizations, each ofwhich focus on health education.

These organizations have a history of work-ing collaboratively on major projects thataffect the profession. Examples of suchcollaborative accomplishments prior to1995 include:

◆ delineating the competencies and keyresponsibilities of entry-level healtheducators (National Commission forHealth Education Credentialing, Inc.,A Competency-Based Framework forProfessional Development of CertifiedHealth Education Specialists. Allen-town, PA: National Commission forHealth Education Credentialing,1996);

◆ establishing a Credentialing system;

◆ establishing baccalaureate approvaland accreditation systems for healtheducation professional preparationprograms;

◆ recommending health education stan-dards for school programs and stu-dents (Joint Committee on NationalHealth Education Standards,National Health Education Standards:Achieving Health Literacy.Atlanta, GA: American Cancer Society,1995); and

◆ developing common definitions for keyhealth education concepts (Report ofthe 1990 Joint Committee on HealthEducation Terminology, Journal ofHealth Education 22(2), 1991).

The national organizations participated inthis forum out of a desire to work togethertoward defining and then achieving goalsand objectives intended to advance theprofession of health education and to speakwith a common voice on issues affecting theprofession.

The participating organizations (see Appen-dix A for a description of each organization)were :

◆ The American Association for HealthEducation (AAHE),

◆ American College Health Association(ACHA),

◆ American Public Health Association:Public Health Education and HealthPromotion Section (APHA-PHEHP),

◆ American Public Health Association:School Health Education and ServicesSection (APHA-SHES),

◆ American School Health Association(ASHA),

◆ Association of State and TerritorialDirectors of Health Promotion andPublic Health Education (ASTDHP-PHE),

◆ Coalition of National Health EducationOrganizations (CNHEO),

◆ Eta Sigma Gamma (ESG),

◆ National Commission for Health Edu-cation Credentialing, Inc. (NCHEC),

◆ Society for Public Health Education(SOPHE), and

◆ Society of State Directors of Health,Physical Education, and Recreation(SSDHPER).

These organizations share a common visionof promoting and improving the public’shealth through education, advocacy, andresearch. Together, they also exemplify thediversity of individuals, work place settings,

OVERVIEW

Overview

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and experience found in the profession. Theorganizations collectively represent stu-dents in colleges and universities studyingto become professionals in health educa-tion, health educators practicing in a vari-ety of sites: schools, colleges and universi-ties, hospitals and clinics, business, indus-try, voluntary health organizations andgovernment, and at a variety of levels: local,regional, state, tribal, national, and inter-national. Two organizations have no indi-vidual members but contribute to nationalleadership for the profession: CNHEO is acoalition of professional health educationorganizations and NCHEC administers thecredentialing process for the profession.

As an outcome of this forum, participantsidentified six focal points to guide the workof national organizations in their efforts toadvance the profession of health educationinto the 21st century:

◆ Professional Preparation

◆ Quality Assurance

◆ Research

◆ Advocacy

◆ Promoting the Profession

◆ Dynamic/Contemporary Practice

Work Between 1995 and 1999This report summarizes the work of thedelegates of the national health educationorganizations since the 1995 forum. It doesnot represent the progress made by indi-vidual practitioners or researchers or ofgroups of health educators working at theinstitutional, local, state, or regional levels.Those involved in the development of thisreport view it as a “work in progress” de-signed to stimulate both thought and ac-tion, and to be updated periodically. Itprovides a basis upon which to build thefuture of the profession and the practice ofhealth education.

In 1996, the Journal of Health Educationpublished a report of the initial forum (vol.27, no. 6, pp. 357-364). To act on theresults of the initial forum, delegates fromthe national organizations participated inover 30 conference calls and additionalface-to-face meetings in conjunction withother conferences between January 1997and December 1999. (See Appendix B for alist of those participating.) They criticallyanalyzed the actions within the six focalpoints of the initial forum, went back totheir national organizations to identify whatthe organizations were doing to accomplishthese recommended actions, and developeda matrix (see Appendix C) that reflectedactions being addressed in 1997. Throughthe process of analyzing gaps, representa-tives returned to the national organizationsa second time asking for their progress asof 1999. This process of considering andreporting on the initial recommendationsalso served to focus attention on the recom-mendations, encouraging the organizationsto consider these areas of professionalresponsibility in their strategic planningand action plans. Indeed, this often hap-pened, and the profession advanced, due inpart to the focus on these common areasduring the time this report was evolving.

Internal/External ActionsFor each focal point listed above, the repre-sentatives of the nine national health edu-cation organizations identified some actionsneeded to move the profession into a dy-namic position for the 21st century. Actionsinclude those internal to the profession(i.e., actions those in the profession couldaccomplish themselves) as well as thoseexternal to the profession (i.e., actions thatwould require efforts by some individual oragency not part of the health educationprofession).

Overview

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Examples of those responsible for actionsinternal to the profession include nationalhealth education professional organiza-tions; college and university faculty respon-sible for preparing future health educators;and health educators, individually and aspart of groups working at institutional,local, regional, state, tribal, national, andinternational levels. Examples of thoseresponsible for actions external to theprofession include health education con-sumers and their family members, employ-ers, university administrators, legislators,leaders of business and industry, regula-tors and funders within governmentalagencies, other health professionals, othereducators, the media, third party payers,accrediting boards, school board members,and the faith community.

For actions/goals external to the profes-sion, health educators individually or ingroups often must stimulate and encourageothers to take the recommended actions.

Communication with Members ofthe ProfessionThis report is part of an ongoing effort tocommunicate with members of the partici-pating organizations and with other healtheducation professionals. That effort hasincluded publishing the proceedings of theinitial forum in the Journal of Health Edu-cation and the Journal of School Health(JOSH), presentations at national confer-ences of participating organizations, andpostings on health education list serves.Delegates shared progress with their orga-nizations in newsletter articles, written andoral reports to boards, and open mikeforums at conferences.

Organization of the ReportThis report is organized with a focus oneach of the six focal points. It representsthe national organizations’ reports of theiractions and priorities. For each focal point,the report includes:

◆ Definition

◆ Introduction

◆ Internal Actions/Goals

◆ External Actions/Goals

◆ Further Actions Needed

The conclusion to this document presentsan overview of the continuing needs of theprofession.

While these suggested actions are notprioritized, we hope that national organiza-tions will continue to use the suggestedactions/ goals when engaged in strategicplanning, and we also hope that individualhealth educators and groups of profession-als will focus their professional energies onaccomplishing many of the suggestedactions/goals.

The viability of the health education profes-sion in the 21st century depends uponhealth educators individually and collec-tively taking responsibility for the profes-sion. This document can serve as a catalystfor such action.

Overview

Focal Point Summaries

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Professional Preparation

DefinitionProfessional preparation is the academiccoursework and associated fieldwork re-quired of students to receive a degree inhealth education. Colleges and universitiesoffer professional preparation for healtheducators at the baccalaureate, masters,and doctoral levels. Health education pro-fessional preparation programs have aresponsibility to provide quality educationfor their students, thus benefiting both theprofession and the public. Such qualityeducation derives from and develops instudents key responsibilities and compe-tencies defined by the profession at boththe entry and advanced levels. Many pro-grams also offer specific courses for thosepreparing to work in various settings (e.g.community/ public health, schools, univer-sities, medical care, or the workplace).Formal accreditation and approval mecha-nisms help ensure the quality of profes-sional preparation programs.

Individuals who take and pass the certifiedhealth education specialist (CHES) exami-nation after they complete their degreework demonstrate their competence inmeeting the responsibilities and competen-cies expected of entry-level health educa-tors. The National Commission on HealthEducation Credentialing (NCHEC) hasresponsibility for developing and adminis-tering these examinations. The Commissionand its network of continuing educationproviders also approve continuing educa-tion offerings for credit toward periodicrecertification.

IntroductionOver 300 institutions in the United Statesoffer health education professional prepara-tion programs. The quality of these pro-grams determines whether or not healtheducators have state-of-the-art skills thatare based on current theory, research, bestpractices, and ethical practices. Healtheducation faculty at colleges and universi-ties are, thus, key to any efforts to movethe profession forward in the 21st Century.National, state, and local health educationorganizations can help faculty members, aswell as individual practitioners, do theirjobs ethically and do their jobs well.

Internal Actions/GoalsRepresentatives of national health educa-tion organizations who attended the “HealthEducation in the 21st Century” meeting in1995 identified 15 actions/goals related toprofessional preparation, which healtheducators working individually or in groupscould take to move the profession forward.Although professional preparation is notgenerally thought of as being within thepurview of professional associations, eachof the organizations represented in thisreport identified specific actions they havetaken, are taking, or are willing to take tohelp ensure that health educators haveoptimal opportunities to receive qualityprofessional training from academic institu-tions on an on-going basis.

FOCAL POINT SUMMARIES



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Professional Preparation - Internal Actions/Goals

• Recruit and train grassroots health educators

• Strengthen mentoring of young professionals

• Strengthen professional preparation programs: undergraduate, graduate, advo-cacy, recruit diverse students

• Identify strategies to draw students to the profession

• Standardize accreditation of programs

• Provide certification and increase the number of Certified Health EducationSpecialists

• Provide inservice training/continuing education for health education profession-als on emerging technology

• Establish mentoring programs

• Adapt curriculum to evolution of the field and the world

• Reinforce pride and commitment in professional preparation and encourageactive involvement in professional associations

• Standardize the practice of the profession: within preservice, the field (withindifferent settings), continuing education

• Educate about technology (make it a part of continuing education and profes-sional preparation programs)

• Include in continuing education and professional preparation programs, in-creased understanding and ability to analyze future trends and impact on healtheducation practice

• Strengthen health educators’ knowledge of the competency framework and thecommonalities of responsibility across health education settings

• Establish a health education training institute

Of the 15 actions/goals identified as inter-nal actions for the profession, only one isnot currently being addressed by one ormore of the 9 professional organizationsrepresented in this document.

◆ Adapt curriculum to evolution of fieldand world.

The national organization representativesfelt it would be inappropriate for any of theorganizations to address this particulargoal directly. National organizations might,

however, work through their various struc-tures to bring together those who do havecurricular responsibilities.

One organization considers one of theinternal actions/goals as its core mission.

◆ Standardize the practice of the profession:within preservice, the field (within differ-ent settings), continuing education.

NCHEC considers this action/goal part ofits core mission. The Commission workscooperatively with other organizations



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through the Competencies Update Project(CUP) to ensure that work on this goalprogresses to keep pace with the field.

At least three of the reporting organizationsaddress each of the following actions/goals.

◆ Recruit and train grassroots health educa-tors.

The American College Health Association(ACHA) and Eta Sigma Gamma (ESG) areboth currently working on this particularaction/goal. Eta Sigma Gamma regularlyinitiates new chapters and new studentmembers. At present, over 100 Chapterswith over 3,200 members exist in theUnited States. Likewise, the ACHA, workingon college campuses, has as one of itshighest priorities, the recruitment, training,and support of peer health educators whoserve as grassroots health educators. Oneof the organization’s primary objectives is toexpose students to public health educationas a field of endeavor. ACHA places particu-lar emphasis on recruiting and trainingstudents from diverse ethnicities and back-grounds. Through its campus-based work,ACHA emphasizes support of and trainingfor young professionals. At its annualmeeting, a number of sessions focus onissues faced by new professionals in thefield.

◆ Standardize accreditation of programs.

The American Association for Health Edu-cation (AAHE) and the Society for PublicHealth Education (SOPHE) provide leader-ship for standardizing the accreditation ofhealth education professional preparationprograms. Through its recognition as alearned society by the National Council onAccreditation of Teacher Education(NCATE), AAHE conducts folio reviews ofprofessional preparation programs thatseek NCATE accreditation. For the past 10years, AAHE and SOPHE have collaboratedon the SOPHE/AAHE Baccalaureate Pro-

gram Approval Committee (SABPAC). Pro-fessional preparation programs in commu-nity health can apply for approval throughthis effort. Approval indicates that theprogram has met the basic framework forthe professional preparation of healtheducators. In 1997, AAHE and SOPHE alsoworked in concert to prepare and distributethe Graduate Standards for Health Educa-tion Professional Preparation.

At the graduate level, the Council on Edu-cation for Public Health (CEPH) accreditsschools of public health as well as graduateprograms in community health educationthat are outside schools of public health.Health education is one of five core publichealth competencies included in CEPH’saccreditation. Both AAHE and SOPHEsupport the work of CEPH. In 1999, CEPHadopted the Graduate Competencies inHealth Education, now referred to as theadvanced-level competencies.

No system exists to review the numerousgraduate health education professionalpreparation programs not affiliated withschools of public health or with emphasesother than community health education. In2000, AAHE and SOPHE launched a taskforce of health education faculty and othersto examine various options for a compre-hensive quality assurance system at theundergraduate and graduate levels.

◆ Strengthen health educator’s knowledgeof the competency framework and thecommonalities of responsibility acrosshealth education settings.

AAHE and NCHEC are willing to provideleadership for this action/goal. AAHE has aTeacher Education Task Force charged withdeveloping new teacher education stan-dards for both the basic and advancedlevels of health education NCATE accredita-tion. This Task Force will build upon thecompetency framework developed throughthe Role Delineation Project and published



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by NCHEC. NCATE and AAHE, SOPHE, andCEPH use this framework as the basis oftheir accreditation processes. All the na-tional health education organizations in-volved in this report except ACHA haverepresentatives on the Advisory Committeeof the Competencies Update Project (CUP).The purpose of the CUP project is toreverify the roles and responsibilities forentry-level health educators and to verifyroles and responsibilities for advanced-levelhealth educators.

Professional preparation programs thatprepare their graduates to take the CHESexamination for certification as a healtheducation specialist must address thecompetency framework. NCHEC offersworkshops to help people prepare to takethe test.

◆ Educate about technology as part ofcontinuing education and professionalpreparation programs.

Nine of the ten organizations provideinservice training or continuing educationabout emerging technologies. ACHA andSOPHE educate health educators abouttechnology as part of their continuingeducation and professional developmentprograms. At its annual meeting in Phila-delphia in 1999, ACHA emphasized con-tinuing education in using technologies forhealth education programs. Following its1999 conference, ASHA offered a workshopthat dealt with the use of technology inhealth education. Both the PHEHP andSHES sections of APHA regularly partici-pate in APHA’s Technology Forum, whichintroduces newly emerging technologiesthat health educators could use in theirprograms and planning efforts. SOPHE andthe Johns Hopkins University’s School ofPublic Health jointly published a paper“Health Education in the 21st Century: AWhite Paper” that outlined current andanticipated societal changes and theirexpected impacts on health education, in

part which emphasized technology. SOPHEand ASTDHPPHE participated in a RobertWood Johnson Foundation project thatidentified Competencies that health educa-tors will need in the new millennium, in-cluding those related to technology.

At least four of the health education organi-zations are addressing the following inter-nal professional preparation actions/goals.

◆ Promote certification and increase thenumber of Certified Health EducationSpecialists (CHES).

NCHEC, ACHA, and the Public HealthEducation and Health Promotion Section ofthe American Public Health Association(APHA-PHEHP) are currently working onthis goal and AAHE indicated a willingnessto assist. Several of the organizations areCategory I providers of Continuing Educa-tion Contact Hours (CECHs) for CHESrecertification, not only for their annualmeetings, but also for other organizationsor substructures (e.g., affiliates, constitu-ents, or chapters) that request such ser-vices. Several of the organizations (APHA-PHEHP, APHA-SHES, ASTDHPPHE,SOPHE, AAHE, and ASHA) offer both mem-bers and nonmembers the opportunity toearn CECHs at their annual meetings,through their various publications, orthrough other means such as distancelearning (e.g., web sites, audiotapes, andvideotapes). SOPHE is the largest providerof CECHs per year, awarding 9,000-10,000CECHs per year through meetings, distancelearning activities, and self-study. In 1999SOPHE was awarded a contract by theHealth Resources & Services Administra-tion (HRSA) to study the impact of healtheducation credentialing on individuals,organizations, and society at large. SOPHEintends to distribute the results of thisqualitative study to health educators,employers, policy makers, and other inter-ested parties.



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◆ Establish mentoring programs.

Although no organization offered to assumeleadership for establishing a mentoringprogram for the profession as a whole, atleast seven organizations (AAHE, APHA-PHEHP, APHA-SHES, ASHA, ASTDHPPHE,SOPHE, and SSDHPERD) currently havementoring programs. The APHA-PHEHPsection leadership participate as mentors inthe APHA Student Caucus mentoring pro-gram. ASHA has a Mentor-a-Student pro-gram that pairs students with professionalmembers who help the students “navigate”the annual meeting and introduce them toother ASHA members. The School HealthEducation and Services Section of APHA(APHA-SHES) and AAHE have similarmentoring programs. The latter two pro-grams urge the member to stay in touchwith the student over time. The PublicHealth Leadership Institute (PHELI) issponsored by ASTDHPPHE, SOPHE, andSSDHPER. This yearlong training experi-ence emphasizes health education andhealth promotion as a foundation forachieving public health goals and the needfor proactive leaders in the field. The men-toring component is essential.

◆ Reinforce pride and commitment in profes-sional preparation and encourage activeinvolvement in professional associations.

AAHE is willing to take the lead for thisaction/goal. Although ACHA focuses onrecruitment of new members, its HealthEducation Section seeks to instill in stu-dent members the importance of having abroad outlook for the profession and en-courages multi-organizational membership.As an interdisciplinary organization con-cerned with the health and well-being ofthe school age individual, ASHA encouragesmulti-organizational membership, andfosters “cross-pollination” across disciplineswithin its organizational structure. Organi-zational committees and task forces do the

majority of the work of the organizationsand provide for participation, allow recogni-tion, and instill a sense of pride amongmembers.

◆ Establish a health education traininginstitute.

SOPHE has indicated a willingness to takethe lead for this action/goal. For the past17 years, ASTDHPPHE has provided leader-ship by coordinating the National Confer-ence on Health Education and HealthPromotion in collaboration with the Centersfor Disease Control and Prevention throughits National Center for Chronic DiseasePrevention and Health Promotion. SOPHE,AAHE and SSDHPER have also partneredin these conferences.

In addition to their annual meetings, manyof the organizations sponsor special train-ing programs and conferences during thesummer months. For example, during itssummer institute, ASHA includes in-depthworkshops related to the health educationstandards (e.g., how participants can usethese standards to prepare instructionalactivities and to assess students’ progress,and how to use technology as a tool forattaining the standards). ASHA has a full-time director of professional developmentwho provides workshops, seminars, andpresentations that are primarily for teach-ers and school administrators. These pre-sentations advocate for quality healtheducation. Several organizations havematerials available for purchase that canguide various training programs.

At least five of the organizations are ad-dressing two of the 15 internal actions/goals.

◆ Strengthen professional preparationprograms: undergraduate, graduate,advocacy, recruit diverse students.

AAHE offered to provide leadership instrengthening professional preparationprograms, as well as recruiting diverse



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students to the profession. ACHA, ASHA,SHES, and SOPHE are already working onthis action/goal and NCHEC is willing tohelp attain it. ASHA includes professionalpreparation as one of its five key goalsadopted in 1998. The School Health Educa-tion and Services Section of APHA (APHA-SHES) is revising a position paper relatedto teacher preparation for non-health edu-cators. The section recommends that allthose in teacher preparation, especiallythose at the elementary level, take onethree-semester hour course beyond a per-sonal health course that focuses on how toteach health. The NCHEC works with pro-fessional preparation programs to assurethat graduates meet the eligibility criteriafor certification in health education.ASTDHPPE and AAHE have several majorprojects focused on strengthening profes-sional programs at historically Black col-leges and universities and Hispanic-servinginstitutions. AAHE projects address HIVprevention, comprehensive school healtheducation, teacher education standards forboth basic and advanced level health edu-cation, NCATE accreditation, developing(with SOPHE) advanced level standards forhealth education professional preparation(described earlier in this report), and qual-ity assurance in professional preparation.

One of SOPHE’s strategic goals is to trackthe gender and ethnicity of its membershipand use baseline data for measuring im-provement in diversity of its membership, apriority for the new leadership within theorganization. SOPHE recently adopted aresolution to eliminate racial and ethnichealth disparities, which calls for the Soci-ety to broaden its membership and leader-ship development. In 1999, ACHA devel-oped special strategies for increasing diver-sity of membership within its Health Edu-cation Section.

SSDHPER and AAHE prepared inservicepolicy guidelines for middle school teacherswho are generalists and teach health along

with other subjects. They are working withstate education agencies and institutions ofhigher education in four pilot states toimplement the policy recommendations.

◆ Identify strategies to draw students tothe profession

AAHE is also willing to take the lead inidentifying strategies for drawing studentsto the profession. As with any professionalorganization, membership recruitment is amajor issue. However, several of the profes-sional organizations have initiated uniqueprocesses to recruit students. APHA- SHESdevotes a portion of its annual meeting tothe presentation of student work and re-search, and provides an award for the“outstanding student abstract.” Through itsmentoring program, APHA-SHES memberswork to retain students in the field. ASHArecruits students to serve as monitorsduring its annual meetings. In return,these students receive complimentaryconference registration and free member-ship in the organization for one year. Fol-lowing graduation, student members ofASHA have a reduced membership fee forone year. In addition to its student awardsprograms, SOPHE received a grant from theCalifornia Endowment to support scholar-ships for students/young professionals toattend its 1999 meetings. The majority ofthe scholarships went to racially and ethni-cally diverse students.

◆ Include in continuing education andprofessional preparation programs,increased understanding and ability toanalyze future trends and impact onhealth education practice.

Six organizations are working on this ac-tion/goal, with NCHEC taking the lead byapproving for continuing education, pro-grams that increase health educators’understanding of and ability to analyze theinfluence of future trends on health educa-tion practice. AAHE, ACHA, APHA-PHEHP,APHA-SHES, ASHA, and SOPHE have



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offered special programs during their an-nual meetings that address this action/goal. AAHE includes issues and trendsthat affect health education as a regularfeature of its annual meeting. ASTDHPPHEhas offered a series of post-conferenceworkshops and coordinated audio trainingconferences for state health departmentsrelated to this action/goal. As part of itsannual meeting, ACHA uses technology todevelop health educators’ ability to usetechnology for analyzing future trends inhealth education.

◆ Strengthen the mentoring of youngprofessionals.

Eight of the organizations are working tostrengthen mentoring of young profession-als. The strategies they use vary from veryformal mentoring relationships to moreinformal matching of students with sea-soned professionals. ESG is willing toprovide leadership for this action/goal asthe profession’s national health educationhonorary society. With many local chapters,each with a faculty sponsor, ESG canpromote the importance of mentoring tonew as well as “alumni” members. Eachorganization has some unique mentoringprocesses. AAHE has a “follow-the-leader”program where a student follows a memberleader for a day at the annual meeting.APHA-SHES encourages the developmentof a long-term relationship between thestudent and the leader. Some organizationshave implemented “first timer” activities towelcome newcomers to meetings and toorganizations. These activities range fromdistributing newcomer ribbons to offeringmore formal social activities and recep-tions.

Thus, one or more of the organizations areworking on most of the internal actions/goals related to professional preparation.Nine of the ten organizations provideinservice training and/or continuing educa-tion for health education professionals on

emerging technology. Both APHA-PHEHPand APHA-SHES regularly participate inAPHA’s technology forum. SOPHE and theJohns Hopkins University School of PublicHealth jointly published ”Health Educationin the 21st Century: A White Paper” thatoutlined current and anticipated societalchanges and their expected impacts onhealth education. In addition, SOPHE andASTDHPPHE participated in a Robert WoodJohnson Foundation project that outlinedcompetencies health educators will prob-ably need in the new millennium.



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• Initiate cooperative agreements among accrediting bodies, employers, and healtheducation programs in program policy development

• Define the body of knowledge of Health Education: (a) integrate body of knowledge/skills into accreditation process

• Define the body of knowledge of Health Education: (b) establish consistenciesacross university programs

• Provide professional preparation in networking and advocacy

• Standardize professional preparation through accreditation of programs:

(a) education about the benefits of accreditation.

• Standardize professional preparation through accreditation of programs:

(b) standardization of the curriculum

• Provide specialization beyond entry-level: (a) differences between levels

• Provide specialization beyond entry-level: (b) skills with specialization

• Look at other professions that have been successful (which may mean reassessingthe definition of entry level).

• Seek health education requirements for all teacher education students

• Infuse the defined body of knowledge and information about the profession ofhealth education in all health education, public/allied health, and teachereducation courses.

Professional Preparation - External Actions/Goals

External Actions/GoalsThe 1995 meeting participants identified11 actions/goals related to professionalpreparation that those external to theprofession could take to further healtheducation in the 21st Century.

◆ Seek health education requirements forall teacher education students.

ACHA supports the action/goal “Seekhealth education requirements…” andASHA, APHA-SHES, and SSDHPER offeredto help with it.

AAHE and SSDHPER indicated that theysupported but were unable to work on theaction/goal:

◆ Standardize professional preparationthrough accreditation programs:

The majority of the health educationorganizations are not addressing mostof these external actions/goals. OnlyAAHE offered to take the lead for any ofthe actions/goals; it agreed to provideleadership for three goals, which SOPHEagreed to assist with through its workwith SOPHE/AAHE BaccalaureateProgram Approval Committee (SABPAC)and the Council on Education for PublicHealth (CEPH).

◆ Define the body of knowledge of HealthEducation (a) integrate body of knowl-edge/skills into accreditation process.

◆ Define the body of knowledge of HealthEducation (b) establish consistenciesacross university programs.



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(a) education about the benefits ofaccreditation.

NCHEC indicated a willingness to workon the above action/goal as well as onthe action/goal “Seek health educationrequirements…” in collaboration with otherorganizations, but no other organizationsindicated that these goals were withintheir spectrum of effort.

SSDHPER supported the following action/goal but was unable to work on it for now:

◆ Initiate cooperative agreements amongaccrediting bodies, employers, andhealth education programs in programpolicy development.

No organization is working on this action/goal or planned to work on it in the nearfuture, perhaps because they saw this asoutside their area of influence.

NCHEC is willing to work collaborativelywith other organizations on the followingactions/goals:

◆ Provide specialization beyond entry-level:(a) differences between levels

◆ Provide specialization beyond entry-level:(b) skills with specialization

The work of the Competencies UpdateProject might well assist in attaining thesetwo actions/goals.

Both AAHE and SSDHPER are willingto work collaboratively on the followingaction/goal, but neither is currentlyworking on it:

◆ Infuse the defined body of knowledgeand information about the professionof health education in all health educa-tion, public/allied health, and teachereducation courses.

SSDHPER would work with other organiza-tions to:

◆ Provide professional preparation innetworking and advocacy.

No other organizations indicated a similarpredilection. For the past three years,however, SOPHE has coordinated anAdvocacy Summit in Washington, DC,and nearly all of the organizations havesupported this summit, both monetarilyas well as by sending representatives asparticipants.

Future ActionsA review of the 15 internal and 11 externalprofessional preparation action/goalsshows that national health educationorganizations are doing more related tothe internal than the external actions/goals. A possible explanation is that theorganizations consider the internal actions/goals within their scope of practice, whichincludes providing opportunities for facultyin professional preparation programs toattend professional meetings and expandtheir professional horizons and body ofknowledge. For membership organizationsto “dictate” what professional preparationinstitutions should do would enter thedomain of the faculty who have responsibil-ity for professional preparation programs.

The national organizations indicate awillingness to work with faculty and practi-tioners to create a climate for sharing whatis happening in the field, to consider futureneeds and directions, and to translatethose discussions into professional prepa-ration programs. The Competencies UpdateProject provides further impetus for healtheducation organizations and faculty inprofessional preparation programs toreexamine how they conduct professionalpreparation and, if needed, to alter theprocess in order to prepare health educa-tors more adequately for the world theywill face.



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Quality Assurance

DefinitionQuality assurance in health educationrefers to professional accountability inconforming to established standards andcriteria in health education. A dynamichealth education profession requires peri-odic review and revision of standards,consistent with new findings in research,theory and practice. Examples of qualityassurance in health education includecertification of individuals, the accredita-tion and/or approval of professional prepa-ration programs in health education, andthe application of health education ethicalstandards.

IntroductionAmong the defining characteristics of aprofession is the ability to ensure qualityin its professional preparation and practice.The health education profession hasaccomplished significant milestones withregard to quality assurance in health edu-cation standards and practice during thelast 30 years. Its work in role delineationand the development of competenciesdistinguish the health education professionfrom many other allied health and publichealth professions, which are only begin-ning to define their outcomes.

Building on the Role Delineation Project’swork, Health Education Certification, aform of practitioner credentialing, beganin 1989 following the incorporation of theNational Commission for Health EducationCredentialing, Inc (NCHEC). This milestoneculminated some 20 years of effort onbehalf of the profession in clarifying itsroles and responsibilities. Since 1989, morethan 6,000 health educators have receivedthe Certified Health Education Specialist(CHES) credential. The CHES process tests

the competencies of entry-level healtheducators and promotes their continuingeducation. Maintaining the CHES creden-tial requires an annual renewal with anadditional requirement of 75 hours ofcontinuing education over a 5-year period.This credentialing process is a primarymechanism for promoting individual ac-countability for conforming to establishedstandards in health education.

The health education profession has alsomade great strides in ensuring quality ofprofessional preparation programs inhealth education. Various bodies provideaccreditation or review of professionalpreparation programs for health educators.The National Council on Accreditation ofTeacher Education (NCATE) working withAAHE accredits programs preparingteachers of health education using theentry-level competencies required for CHEScredentialing. The SOPHE/AAHE Baccalau-reate Approval Committee (SABPAC)approves baccalaureate programs in com-munity health education using the CHEScompetencies. The Council on Educationfor Public Health (CEPH) accredits Schoolsof Public Health awarding Masters of PublicHealth degrees as well as Masters degreeprograms in Community Health Educationoutside of Schools of Public Health.

During the last 5 years, several healtheducation organizations developed theadvanced-level Competencies that haveinfluenced both professional preparationprograms and continuing education ofthe currently employed health educationworkforce. CEPH has endorsed theseadvanced-level Competencies.

Several studies have documented theimpact of the entry-level Competencieson professional preparation programs andother areas (see references). Academicinstitutions receive feedback related to theperformance of graduates on the CHESexamination, facilitating greater potential

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congruence of professional preparationprogram offerings and standardizedCompetencies.

Internal Actions/GoalsParticipants at the 21st Century meeting in1995 identified eight actions/goals withinHealth Education as priorities for improvinghealth education’s approach to qualityassurance.

existing codes of ethics and presentingthe draft unified code at meetings of eachCNHEO member for profession-wide input.All nine members of the CNHEO ratifiedthe code of ethics for the health educationprofession by November 1999. The Coali-tion and its member organizations aredisseminating copies of the Code throughprofessional journals, newsletters, text-books, and other channels.

Of these eight internal quality assurancegoals, four are being pursued by three ormore national health education organiza-tions:

◆ Maintain a uniform code of ethics

◆ Define (a) core components of healtheducation programs, model standardsfor health education programs;

◆ Define (b) core competencies for healtheducation preparation programs andaccreditation.

◆ Define body of knowledge/skills ofhealth education

The health education profession can beproud of adopting a uniform code of ethicsfor the profession in 1999. The CNHEOtook the lead in combining and adapting

Since 1995, organizations have also madeprogress in developing program standards.At least one organization is leading effortsto define core components of health educa-tion programs and model standards forhealth education programs; four organiza-tions are supporting this task. In 1996,ACHA initiated a Task Force on HealthPromotion in Higher Education to developquality improvement indicators for healthpromotion in higher education. The taskforce drafted standards of practice forhealth promotion in higher education infive areas: (1) leaders demonstrate a capac-ity for community-based health promotion;(2) activities integrate with and complementthe mission of its institution; (3) use of acollaborative process; (4) cultural compe-tence and inclusiveness when working with

Quality Assurance - Internal Actions/Goals

• Maintain a uniform code of ethics

• Actively seek accountability from consumers

• Establish peer-review panels and/or technical assistance teams

• Develop a mechanism for the systematic, continuous evaluation of the profession

• Define: (a) core components of health education programs, model standards forhealth education programs

• Define: (b) core competencies for health education preparation programs andaccreditation

• Arrange for liability insurance options

• Define body of knowledge and skills of health education

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to this process through their participationin the CUP Advisory Committee. Comple-tion is expected in 2001.

One organization offers liability insuranceoptions for health education professionals;no other groups expressed interest insupporting this action/goal.

Of all priorities internal to the profession,only one had no organizational primaryor secondary support:

◆ Actively seek accountability fromconsumers.

External Actions/GoalsThe 21st Century meeting in 1995 identified12 actions/goals important for qualityassurance in health education by thoseexternal to the profession:

multicultural populations and demonstra-tion of competence in addressing issues ofdiversity and health; and (5) programs builton and conduct quantitative and qualitativeresearch.

Two organizations—AAHE and SOPHE—are jointly developing a comprehensive,coordinated effort (Task Force on QualityAssurance 2001-2003) to ensure qualityat the undergraduate and graduate-levelsof professional preparation in health educa-tion. Participation in accreditation reviewsis voluntary and not all professional prepa-ration programs in health educationundergo such review. The goal of a taskforce formed by these two organizations isto develop a comprehensive, streamlinedsystem for quality assurance in healtheducation at the entry- and advanced-levelsof practice. The task force with profession-wide involvement will be initiated in 2000and is expected to complete its work in 36months.

No single organization is taking the leadfor the following action/goal, but oneorganization supports it.

◆ Establish peer review panels and/ortechnical assistance teams

ASTDHPPHE periodically provides technicalassistance consultants or teams to statehealth departments upon request.

No single organization provides profession-wide leadership for the action/goal.

◆ Develop a mechanism for the systematic,continuous evaluation of the profession.

Collectively, however, the profession isaddressing this goal through the Compe-tency Update Project (CUP). In 1998 theNational Commission for Health EducationCredentialing, Inc. initiated the CUP toreview and update the entry-level healtheducation competencies and to verify theadvanced-level competencies. All ten healtheducation national organizations contribute

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Three or more professional organizationsare pursuing eight of the 12 actions/goals.

◆ Require credentialing nationally topractice and have it specified in jobdescriptions;

◆ Require credentialing nationally to prac-tice and have it specified in requiredknowledge, abilities and skills;

◆ Require credentialing nationally to prac-tice and have it specified in recruitmentand retention;

◆ Require credentialing nationally to prac-tice and have it specified in requirementsand guidelines for jobs;

◆ Include health education competenciesin standardized assessments;

◆ Develop and adopt model standards forhealth education programs;

◆ Publicize the code of ethics; and

◆ Participate in review boards.

Several professional organizations sup-ported the four actions/goals related torequiring credentialing nationally to prac-tice, although no one group indicated aleadership role. NCHEC is considering amarketing program that promotescredentialing to practice health educationand three organizations indicated willing-ness to support the initiative. As of 1999,one state required CHES certification foremployment as a health educator by thestate and several other states include“CHES preferred” in job descriptions.

One organization expressed willingness toassume leadership for including healtheducation competencies in standardizedassessments, and two groups offered sup-port. Two organizations are developing andadopting model standards for health educa-tion programs, and two organizationsoffered support.

Quality Assurance - External Actions/Goals

• Standardize professional practice

• Require credentialing nationally to practice and have it specified in (a) jobdescriptions (Certified Health Education Specialist preferred)

• Require credentialing nationally to practice and have it specified in (b) requiredknowledge, abilities, and skills

• Require credentialing nationally to practice and have it specified in (c) recruitmentand retention

• Require credentialing nationally to practice and have it specified in (d) requirementsand guidelines for jobs

• Include health education competencies in standardized assessments

• Develop and adopt model standards for health education programs

• Publicize the code of ethics

• Include health education in monitoring teams/actions related to standards

• Participate in review boards

• Involve consumers in establishing quality assurance in health education

• Provide adequate resources

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Two organizations are taking leadership topublicize the code of ethics, while threeadditional groups offered support.

Several other organizations are participat-ing on review boards to help promote qual-ity assurance. For example, SSDHPER,ASTDHPPHE and SOPHE identify memberswho can serve on site review teams foraccreditation/ approval bodies.

The remaining four actions/goals in theexternal quality assurance area lacked anyform of organizational support.

◆ Standardize professional practice.

◆ Include health education in monitoringteams/actions related to standards.

◆ Involve consumers in establishing qualityassurance in health education.

◆ Provide adequate resources.

No national organization identified itself ashaving a leadership role for includinghealth education in monitoring teams/actions related to standards; some workinggroup participants considered this action/goal as a responsibility of state agenciessuch as departments of education orhealth.

Future ActionsIndividually and collectively health educa-tion organizations are engaged in or broadlysupport quality assurance efforts for theprofession. One or more professional orga-nizations are pursuing more than 75% ofthe internal and external actions/goals.During this review process, participantssuggested rewording several actions/goals.For example:

◆ Regarding the four actions/goals relatedto requiring CHES in employment, etc.,more groups would support the goals ifthe word “require” were replaced with“encourage,” “support,” or “recommend.”

◆ Regarding inclusion of health educationcompetencies in standardized assess-ments, support might increase by re-wording the objective to include healtheducation competencies in “standards ofprofessional practice” (i.e., versus stan-dardized assessments).

Since the organizational survey did notprovide a working definition of “leadership”or “support” roles, some groups hesitated toidentify themselves as leaders for the pro-fession, although they engage in activitiessupporting the goal. For example, severalgroups indicated they “participate in reviewboards” but no group considered itself thelead group for the profession.

A review of quality assurance actions/goalsboth internal and external to the professionsuggests that the professionals in the fieldof health education might need more expe-rience with a variety of quality improvementmechanisms before they can articulate acomplete list of priorities. However, severaldirections are noteworthy.

With a newly adopted Code of Ethics, na-tional organizations have a document theycan disseminate widely to health educatorsas well as to employers and other audi-ences. For the Code to stay current, theCNHEO must commit to a system for revis-ing and updating the code in the comingyears.

A task force initiated through the jointefforts of two organizations is to develop acomprehensive, coordinated system ofquality assurance for professional prepara-tion and will provide a major underpinningto this arena. The initiative has as part ofits operating principles to engage profes-sion-wide discussion and involvement inadopting such quality assurance ap-proaches. It is anticipated such a systemwill be proposed for implementation in thenext three years. The issue of “providing

Quality Assurance


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adequate resources” will be a major item formoving ahead with any revised and/or newsystem.

Currently one organization provides techni-cal assistance teams at the state level.Other organizations could expand efforts inthis area to address the needs of variouspractice settings beyond state health de-partments such as worksites, schools, andmanaged care organizations.

Currently one organization provides liabilityinsurance options for the profession. It isunclear how many individuals in the pro-fession subscribe to this service, the num-ber of employers now providing such insur-ance, and how such insurance has func-tioned in terms of protecting individualhealth educators, organizations, or thepublic. Such information could help orga-nizations determine whether to offer liabil-ity insurance as a centralized professional-wide service.

Given discussions of credentialing systemsfor public health workers and worksitehealth promotion specialists, the professionneeds to expand its involvement on reviewboards or similar groups external to theprofession. Such other credentialing- sys-tems could significantly affect acceptance ofhealth education certification.

The national health education organiza-tions struggle with how to involve or reachout to consumers with quality assuranceefforts—both involving consumers in estab-lishing quality assurance in health educa-tion and in actively seeking accountabilityfrom consumers. Examining how otherhealth professions have broached thisarena might inform future health educationefforts, whether through the CNHEO, indi-vidual organizations, or practitioners.

Members of the health education professionneed to find ways of communicating stan-dards and relating those standards tooutcomes. Although the 1995 meeting

participants did not identify actions/goalsrelated to accountability for outcomes,increased emphasis on accountability in allareas of society suggests this will be in-creasingly important in the 21st century. Atleast one major study is underway to evalu-ate the relationship of health educationcredentialing to outcomes. The results ofthis study might provide marketing infor-mation that health educators and theirprofessional associations can use withpractitioners, professional preparationfaculty and institutions, employers, govern-mental bodies and society at large.

Developing a mechanism for the system-atic, continuous evaluation of the profes-sion might be the responsibility of theCNHEO rather than any one organization.Periodically convening meetings such asthe initial 21st Century forum could providea mechanism to evaluate the professionand set goals for the future.

◆ Widely disseminate the Code of Ethicsthroughout the profession as well asto employers and other audiences. Inaddition, the CNHEO must commit toa system for revising and updating thecode in the coming years.

◆ Work with the profession to develop acomprehensive, coordinated system ofquality assurance for professionalpreparation in health education.

◆ Expand efforts to provide technicalassistance teams at the state level tostate health departments, worksites,schools, and managed care organiza-tions.

◆ Assess the extent to which health educa-tors may be interested in obtainingliability insurance and expand theprovision of such insurance throughmore health education organizations orthrough a central service, if necessary.

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◆ Expand involvement of health educatorson review boards or similar groups exter-nal to the profession that may impacthealth education credentialing.

◆ Identify feasible alternatives for thehealth education profession to involve orreach out to consumers in its qualityassurance efforts—both involving con-sumers in establishing quality assurancein health education and in actively seek-ing accountability from consumers.

◆ Communicate to external audiencesabout standards of the health educationprofession and how such standardsrelate to outcomes, e.g., how healtheducation credentialing relates to out-comes.

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• Assure translation of research to practice and from practice to research

• Create study groups between research and practice groups

• Develop a technical assistance program modeled after the extension service

• Establish training institutes/centers: theory-research-practice

• Establish a research institute think-tank with money

• Ensure research that will provide articulation of theory and practice

• Demonstrate the efficacy of health education

• Promote health education professionals with skills for structuring programs andresearch that will demonstrate the efficacy of health education

Research - Internal Actions/Goals

Research

Research

DefinitionHealth education research is both appliedand basic. It draws from theoretical con-structs found in educational, social, behav-ioral, and life sciences. Health educationtheory and research derives from and usesrigorous social science methods. Theknowledge derived from this research formsthe basis of the practice of health educa-tion. Health educators apply these con-structs to improve individual and popula-tion based health. The practice of healtheducation, in turn, influences health edu-cation theory and research.

IntroductionA cursory view of today’s world reveals alarge range of health and social problemsthat call for solutions based on knowledge.Future successes in the health educationprofession require demonstrating the effi-

cacy of health education interventions andassuring translation of research into prac-tice and practice into research. In the1960s, AAHE (School Health Division,AAHPERD) published a synthesis of re-search in areas of school health educationwhich was used widely. The professionneeds to improve communication of re-search findings internally and externallyand create health education programs andinterventions based on sound theory anddemonstrated methods and strategies.Health educators must become more adeptat documenting success through evidence-based research that demonstrates efficacyand effectiveness.

Internal Actions/GoalsAt the 1995 meeting, representatives ofhealth education organizations identifiedeight actions/goals related to research thathealth educators could take to move theprofession of health education forward inthe 21st century.


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Subsequent to the 1995 meeting, severalnational health education organizationsindicated they are addressing four of theseinternal actions/goals.

◆ Assure translation of research to practiceand from practice to research;

◆ Demonstrate the efficacy of health edu-cation;

◆ Promote health education professionalswith skills for structuring programs andresearch that will demonstrate the effi-cacy of health education; and

◆ Ensure research that will provide articu-lation of theory and practice.

The national organizations recognize theimportance of research and scholarly activ-ity in supporting the profession of healtheducation. Most attempts at translation ofresearch to practice and vice versa occurthrough traditional means such as confer-ence sessions, continuing education oppor-tunities and journal articles. For example,program planning committees for variousprofessional conferences and meetingsoften select proposed sessions based on theuse of research in practice and vice versa.Segments of professional programs oftenfocus on the efficacy of health education,especially in school settings. Externalfunding provides professional organizationsopportunities to publish and disseminateevaluation of health education initiatives.This funding allows communication ofprogrammatic description and evaluation,as well as commentary on strengths andweaknesses of research findings. Oneorganization collaborated with CDC in 1995on publishing a research agenda for healtheducation and is now in the process ofupdating it. Internet and other technologiesprovide opportunities for researchers toconvey their research findings to practitio-ners.

No national organizations participatedirectly in activities that address the otherfour internal actions/goals.

◆ Create study groups between researchand practice groups;

◆ Develop a technical assistance programmodeled after the extension service;

◆ Establish training institutes/centers:theory-research-practice; and

◆ Establish a research institute think-tankwith money.

Some organizations are addressing theseaction items indirectly. For example, AST-DHPPHE and SOPHE collaborated with theNational Center on Injury Prevention todevelop a website that highlights the trans-lation of research to practice. ESG has setaside monies for health education researchavailable on a competitive basis to localchapters. Furthermore, ESG supports aprocess that helps fund efforts to translateresearch to practice. NCHEC is gatheringdata about certified professionals’ needs forprofessional development. Many of thehealth education journals emphasize re-search-practice linkages.

Representatives of the organizations whoparticipated in the working group discussedseveral potential reasons for the lack ofdirect focus on the above goals/actions.Perhaps these goals/actions are moreaccurately external goals or actions.Another possible explanation is that partici-pants found some goals/ actions unclearor redundant. For example, the differencesbetween “Assure translation of researchto practice and from practice to research”and “Ensure research that will providearticulation of theory and practice” wereunclear. Other goals/actions, such as theestablishment of a think-tank are moreappropriately the purview of post-secondaryinstitutions or government agencies.

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Of the nine external actions/goals, three ormore professional organizations addressedfour of the actions/goals:

◆ Increase funding for health educationresearch;

◆ Encourage Institutions of Higher Educa-tion to actively support health educationfaculty involvement in applied researchat the community level;

◆ Promote the acceptance of applied re-search in peer reviewed journals; and

◆ Disseminate research information topractitioners.

AAHE and SOPHE are seeking increasedfunding for health education research.AAHE and ASHA promote applied researchin peer-reviewed journals and the dissemi-nation of research information to practitio-ners through specialized sections of theJournal of Health Education and the Journalof School Health. SOPHE’s new journal

• Increase funding for health education research

• Seek funding of research relevant to health education and include health educatorsas the researchers

• Promote giving equal weight to action-oriented, inquiry research in promotion andtenure decisions in Institutions of Higher Education

• Encourage Institutions of Higher Education to actively support health educationfaculty involvement in applied research at the community level

• Promote funders encouraging faculty to be involved in the community level

• Promote the acceptance of applied research in peer reviewed journals

• Disseminate research information to practitioners

• Involve health educators in health status research connecting outcomes andindicators

• Increase communication between and among researchers (data collectors) andhealth educators

Research - External Actions/Goals

Research

External Actions/GoalsParticipants at the 1995 meeting identifiednine research-related actions/goals thatrequire involvement of people, groups, andorganizations outside the profession ofhealth education to move the health educa-tion profession forward in the 21st century.

Health Promotion Practice connects researchto practice and practice to research.

Three organizations (ASHA, ASTDHPPHE,and SOPHE) are interested in encouragingInstitutions of Higher Education to supportfaculty involvement in applied research atthe community level. Organizational repre-sentatives working on this project initiateddiscussions with the director of the HarvardProject, a CDC-funded initiative for increas-ing partnerships between colleges and localcommunities that improve health outcomesfor children and youth in the community.The discussion focused on potential part-nerships between the Harvard Project andthe health education profession around


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such issues as professional preparation ofhealth teachers and the academic rewardsystems within institutions of higher edu-cation. The Harvard Project provides oneforum where representatives of nationalhealth education organizations can encour-age presidents of colleges and universitiesto reward those who apply research topractice settings at the same level as theyreward scholarly productivity and teaching.

Currently, CDC funds 20 Prevention Re-search Centers that have strong appliedresearch agendas across diverse topics andamong diverse populations. Potentially,health education organizations could workmore closely with these centers to dissemi-nate cutting-edge community-based healtheducation research.

At least one national health educationorganization is addressing or has indicatedan intention to address each of the remain-ing external actions/goals.

◆ Seek funding of research relevant tohealth education and include healtheducators as the researchers.

◆ Promote giving equal weight to action-oriented, inquiry research in promotionand tenure decisions in institutions ofHigher Education.

◆ Promote funders encouraging facultyto be involved at community level.

◆ Involve health educators in health statusresearch connecting outcomes andindicators.

◆ Increase communication between andamong researchers (data collectors) andhealth educators.

Certainly individual health educators andhealth education professional preparationprograms within Institutions of HigherEducation have key roles to play in ad-dressing research-related actions/goals.As the profession of health education be-

comes better recognized, funding availablefor health education research is likely toincrease.

Future ActionsAs part of the dialogue around these Goals,several of the health education professionalorganizations have begun considering an“Encyclopedia of Health Education Re-search.” The Encyclopedia would representa synthesis of research in health educationthat includes all work settings, thus con-necting the profession. Topics for inclusionin this Encyclopedia might encompassresearch on historical developments in eachhealth education work setting, philosophi-cal and theoretical approaches to healtheducation practice, models of effectiveprograms, professional preparation issues,behavior change, analysis of health mes-sages, effectiveness of instruction forhealth, and status of the profession invarious states. It would also address ele-ments of quality research and criteria forevaluation of quality research. A committeeto oversee the work might include membersfrom AAHE’s Research Coordinating Board,ASHA’s Research Council, SOPHE’s Re-search Agenda Committee, and the Acad-emy of Health Behavior. The AmericanEducational Research Association’s (AERA)Encyclopedia of Educational Research mightserve as a model for the work. AERA’sencyclopedia has included a synthesis ofresearch in health instruction for manyyears. This compilation could demonstratethe efficacy of health education in a varietyof settings and provide guidance for plan-ning effective health education programsand interventions. The proposed Encyclope-dia might also provide a foundation for thebody of knowledge that comprises thediscipline of health education.

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Advocacy

DefinitionHealth educators, professional associa-tions, professional preparation programs,and public and private health educationorganizations play a major role in the devel-opment, diffusion, and evaluation of poli-cies that influence health. The World HealthOrganization defines advocacy for healthas “a combination of individual and socialactions designed to gain political commit-ment, policy support, social acceptance,and systems for a particular health goal orprogram.” The goal of advocacy efforts isto arouse public concern and mobilizeresources and forces in support of an issue,policy or constituency.

IntroductionCollaborative efforts, including buildingrelationships with policy makers and themedia and developing coalitions, can be-come a strong catalyst for effective advo-cacy. These efforts succeed by maximizingthe power of individuals and groupsthrough joint actions and by bringingtogether individuals from diverse constitu-encies to deal with often complex issues.National health education organizationshave made significant progress since the1995 report in advocating both for theprofession and for health-promoting poli-cies, programs and services. Individualhealth educators and national and statehealth education organizations increasinglyrecognize the need for developing effectiveskills for advocating at the institutional,local, state, tribal, national and interna-tional levels. Indeed, the future of theprofession might well rest, in part, on thesuccess of these and future efforts.

Internal Actions/GoalsThe following chart contains the 15 internaladvocacy actions/goals identified by par-ticipants at the 1995 meeting.

Advocacy


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Of the 15 advocacy actions/goals thatrequire action by the members of the pro-fession, 12 have one or more professionalorganizations already working on them.Six organizations have offices in the greaterWashington, DC, area, facilitating theirinvolvement in legislative and policy-making activities. ASHA has a part-timeWashington-based legislative consultant onretainer. However, none of the organizationshas its own full-time staff member devotedto health education advocacy, which ham-

pers the potential for timely, sustainedpolitical influence on key issues. Severalof the professional organizations limit theiradvocacy-related activities because they aresubstructures within larger organizationsthat establish organizational policies andset advocacy priorities. As nonprofit orga-nizations with 501(C)(3) status, nationalhealth education organizations must com-ply with legal restrictions on lobbying andcampaigning.

Advocacy

• Establish national organizations to provide training to prepare advocacy speakerteams

• Verify a united voice, common messages and advocacy for the lay person

• Include congressional districts as part of national organization membership, andemail addresses

• Establish a health education political action committee

• Provide health education political action advocacy kits

• Establish health education public relations services (regular press releases,information on/about health education for the nation)

• Develop a system for evaluating and recognizing friends of health education instate, national elected offices and sharing this information across health educationnational organizations

• Develop a marketing campaign to improve health education perception and needat the local and national level

• Define for the consumer the appropriate expectation for health education

• Market understanding within the profession: who and what we are, services weprovide, and outcome of services

• Seek representation among and for diverse groups in communities

• Provide opportunities within the elected leadership and on professional committeesfor new professionals and students

• Increase involvement in political process/enhance political action for healtheducation

• Develop multi-organization strategy plan to include building alliances with otherperipherally related professions

• Increase power, leverage, and money access to media (e.g., own cable station),board membership on multinational corporations

Advocacy - Internal Actions/Goals


33

A jointly sponsored Health EducationAdvocacy Summit that SOPHE hosts ad-dresses three of the internal actions/Goals:

◆ Verify a united voice, common messages,and advocacy for the lay person;

◆ Provide health education political advo-cacy action kits; and

◆ Increase involvement in political pro-cess/enhance political action for healtheducation.

The first two annual Summits (held in1998 and 1999) brought 10 national healtheducation organizations together for thefirst time to develop a common advocacyagenda and to advocate collectively forthese issues on Capitol Hill. A planninggroup with representatives from the varioushealth education organizations determinedSummit advocacy priorities, reviewed factsheets, provided training during the sum-mits, and accompanied delegates on Con-gressional visits. By providing training forkey association leaders, the Summits alsoprovided the catalyst for participatinggroups to provide subsequent training,materials, and other resources to theirmembers. To promote advocacy effortsamong their members, the organizationshave conducted special sessions at annualconferences, published newsletter andjournal articles, developed advocacy webpages, and sent targeted mailings. Severalorganizations have developed politicalaction kits. ESG published a special mono-graph on advocacy in 1999.

Many of the membership organizationshave legislative or advocacy committeesthat monitor legislation. Several have legis-lative action trees or a FAX/email system toalert chapters, districts, affiliates, or theirmembers of a need to take quick action onsome policy issue affecting health educa-tion. The professional associations sharetheir alerts with each other to strengthenthe response on a specific issue. Almost all

of the organizations have processes thatguide the development of formal positionstatements or resolutions on various is-sues. Several organizations specify advo-cacy as one of their primary Goals.

Almost all of the organizations indicatedcurrent activities or support for the action/goal.

◆ Develop a marketing campaign to im-prove health education perception andneed at the local and national levels.

Although no group offered to take the leadon this goal, the CNHEO has developedtwo print materials that could assist inaddressing the goal. ASHA is developing amanual for marketing the concept of schoolhealth among one’s peers within a schoolsetting and participates in a social market-ing group that is developing common lan-guage to use in marketing programs forpromoting school health with various audi-ences.

The Advocacy Summits and other advocacyefforts will continue and could provide amechanism for accomplishing other ac-tions/goals:

◆ Establish national organizations toprovide training to prepare advocacyspeaker teams, and

◆ Develop a multi-organization strategyplan to include rebuilding alliances withother peripherally related organizations.

Internet access and email have significantlyincreased the ease of sharing advocacystrategies and action alerts to other healtheducators and national organizations, aswell as communicating our needs andviews to policy makers and the media.

Of the 15 actions/goals, at least onenational organization is addressing allbut three.

Advocacy


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◆ Develop a system for evaluating andrecognizing friends of health educationin state, national elected offices andsharing this information across healtheducation national organization.

◆ Increase, power, leverage, and moneyaccess to media (e.g., own cable station),board membership on multinationalcorporations.

◆ Include congressional districts as partof national organization membership,and Email addresses (although bothsoftware and website programs exist toidentify congressional districts for indi-viduals by zip code).

Although some groups have awards pro-grams that have recognized political ormedia figures for their support for healtheducation, there is no mechanism for moresystematically sharing this informationamong the national organizations.

The profession looks to the CNHEO forleadership on goals that require organizingthe profession and reaching out to periph-erally related professions.

External Actions/GoalsThe 1995 meeting participants identified14 advocacy goals external to the profes-sion.

Advocacy

• Take steps to establish partnerships with other professions engaged in researchand teaching within universities, business, organizations, health care, schools.

• Place more emphasis on primary prevention, early intervention.

• Have health educators included in recommendations for policy/ legislative develop-ment as well as in developing and reviewing relevant policies/legislation.

• Include health education in appropriate legislation.

• Establish legislative links for health education as a profession.

• Connect profession with power brokers, create teams (for education, advocacy) ofhealth educators with legislatures, community leaders— meeting, conferences.

• Develop policy leadership.

• Encourage health educators to work toward elected and appointed policy makingpositions (e.g., community action, multinational boards, school boards, educationand health care reform, other professional organizations, state boards).

• Seek inclusion of the health education profession in legislative language.

• Seek legislative mandates for comprehensive school health education.

• Publicize the profession as a consumer advocate.

• Address health education categorical funding (locally and nationally).

• Seek continued involvement by health educators in the creation of Healthy Peopleand other documents.

• Initiate state plans for health education with state departments of health andeducation.

Advocacy - External Actions/Goals


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One or more of the national health educa-tion organizations are addressing all butone of the external advocacy actions/goalsby developing systems to influence policyand achieving significant policy changes insupport of health education.

The two goals that have the greatest num-ber of organizations currently engaged orwilling to be supportive are:

◆ Place more emphasis on primary preven-tion/early intervention, and

◆ Establish legislative links for healtheducation as a profession.

There is also much support for goals re-lated to including health education inlegislative or policy language. In 1997-98,SOPHE took the leadership in obtainingrecognition by the Department of Labor andCommerce for the distinct occupationalclassification of “health educator.” As aresult, the federal government and stateswill gather data on the geographic distribu-tion, salaries, and other essential data forthe profession, using this definition:

Health Educators—Promote, maintain,and improve individual and commu-nity health by assisting individualsand communities to adopt healthybehaviors. Collect and analyze datato identify community needs prior toplanning, implementing, monitoring,and evaluating programs designed toencourage healthy lifestyles, policies,and environments. May also serve asa resource to assist individuals, otherprofessionals, or the community, andmay administer fiscal resources forhealth education programs.

Representatives of the health educationprofession contributed to and commentedon broad policy-related documents such as“Essential Public Health Services” and“Healthy People 2010,” both of which pro-

vide guidance for policy and resourceallocation at the federal, tribal, regional,state, and local levels. The Health Educa-tion Advocacy Summits have promotedincreased funding for health education-related programs and the overall CDCfunding increased 15 percent in 1999. ThePublic Health Leadership Institute providesadditional opportunities for health educa-tion professionals to influence policy deci-sions directly or through developing im-proved networking skills and opportunities.

Several actions/goals have only weaksupport and no on-going leadership:

◆ Develop policy leadership.

◆ Encourage health educators to worktoward elected and appointed policy-making positions.

◆ Connect profession with power brokers.

No organizations expressed current activityor interest in working on the actions/goalsof:

◆ Publicize the profession as a consumeradvocate.

Perhaps this reflects national organizations’roles as representatives of their membersand not of consumers, so the organizationshave limited access to consumers.

Future ActionsTo continue progress in advocating forhealth education as a profession as well asfor its service goals, national health educa-tion organizations can maintain andstrengthen their efforts by:

◆ Continuing strategies for systematic,collaborative training of health educationprofessionals in advocacy skills;

◆ Continuing to prioritize advocacy issuescollaboratively, developing and sharingfact sheets and advocacy alerts; and

Advocacy


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◆ Continuing to work through state andnational coalitions to support and pro-mote the profession of health educationas well as health education initiatives.

Strengthening advocacy efforts also re-quires a systematic process of preparingprofessionals with these skills. Policy andmedia advocacy are not thoroughly taughtin health education professional prepara-tion programs.

Through the work of the Advocacy Summitand the sharing of action alerts, healtheducation organizations are building ontheir advocacy efforts. CNHEO is workingon a system for sharing advocacy effortsand accomplishments in order to providea more unified voice for health education.No structure exists, however, for sharingamong health educators the accomplish-ments of public leaders outside of healtheducation.

Long-term plans need to consider ways toprepare, encourage, and support healtheducators as decision-makers throughappointments and elections to positionsof power.

Advocacy


37

Promoting the Profession

DefinitionPromoting the profession involves advocat-ing for the employment and promotion ofprofessionally prepared, qualified individu-als to fill health education positions. Pro-moting the profession involves informingemployers, third party payers, governmen-tal regulatory and funding agencies, andthe public at large about the skills andcompetencies of practicing health educa-tors.

IntroductionHealth education meets the definition ofa profession based on the criteria whichconstitutes a profession: a common bodyof knowledge, a research base, a code ofethics, a common set of skills, qualityassurance, and standards of practice. Theprofession of health education includes allthese elements, as evidenced by a voluntaryprofessional credentialing process in which

areas of responsibility and key competen-cies are specified. Those competencies alsoprovide a curricular framework for collegesand universities that offer degree programsin the field at the baccalaureate, masters,and doctoral levels.

The U.S. Department of Labor recognizeshealth education as a distinct occupationalclassification.

The Coalition of National Health EducationOrganizations (CNHEO) was formed in partto provide a unified voice and promote theprofession. In 2000, the Coalition publisheda unified Code of Ethics for the profession.

Internal Actions/GoalsParticipants at the 1995 meeting identified18 actions/goals related to promoting theprofession that those in the professioncould take to move health education for-ward in the 21st Century.



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• Take steps to establish partnerships with other professions engaged in researchand teaching within universities, business, organizations, health care, schools.

• Coalesce health education groups and associations

• Break down the “camps” (MS, MPH, DrPH, PhD), increasing permeability

• Establish a common code of ethics

• Improve and strengthen credentialing beyond current entry-level credentialing andprovide specialization

• Strengthen the CNHEO through improved communication between Coalition del-egates and association members. Work toward united commitment (time, money,staff, resources)

• Clarify and distinguish Health Education vis-à-vis health promotion and otherrelated professions. Identify positive and appropriate interfaces

• Enhance the knowledge and meaning of health education professionals (generic,role delineation, program framework, commonality across sites)

• Promote credentialing of professionals (licensure, certification

• Arrange for third party payment for health education

• Require credentialing nationally to practice

• Develop a unified professional association with staff and advocacy

• Recognize health education as an academic discipline

• Establish a national job clearinghouse

• Ensure the identification of health education in the manpower job classification

• Designate health education as a profession within the Bureau of Health Professions(definition of legitimate providers of health services)

• Develop a profile of health education profession’s demographics

• Describe the state of the profession (demographics, area of practice, preparation,and salary)

• Nurture health educators for elected and appointed offices, locally and nationally

Promoting the Profession - Internal Actions/Goals

Based on the discussion, the task forceomitted one action/goal the membersconsidered redundant (“Ensure the identifi-cation of health education in the manpowerclassification.” Through their collectiveefforts, the national organizations as wellas individuals within the profession haveaccomplished 3 of the 17 remaining inter-nal goals/ actions. These accomplishments

show how the combined efforts of nationalhealth education organizations can movethe health education profession forward.

◆ Designate health education as a profes-sion within the Bureau of Health Profes-sions.

Through the collaborative efforts of profes-sional organizations with leadership from



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SOPHE, the Department of Labor nowidentifies health education as an occupa-tion classification.

◆ Establish a common code of ethics.

As of November 9, 1999, all CNHEO mem-ber organizations had approved or acceptedthe same unified Code of Ethics for thehealth education profession. Developing thecode by combining two professionalorganization’s codes of ethics into onecommon code took over three years.

◆ Establish a national job clearinghouse.

Although many of the actions have beenaccomplished through the collective effortsof professional organizations, it is recog-nized that individual health educators and/or universities and colleges can also provideleadership in achieving goals identified bythe profession. This is one such example.Currently, there are several national jobclearinghouses available on the Internet.Having a national job clearinghouse allowspotential employees access to health educa-tion positions throughout the U.S. andprospective employers a place to advertise.National health education organizationsalso provide job banks at professionalconferences and meetings and advertisepositions in their newsletters and journals.These positions have the potential to beviewed by a diverse audience.

Overall, of the original 18 goals, one wasomitted leaving 17 goals. Of those 17 goals,5 (30%) have been or are being accom-plished. Of the remaining goals:

◆ eight goals have five or more professionalorganizations working on:

• Establish a common code of ethics.

• Strengthen the CNHEO throughimproved communication betweenCoalition delegates and associationmembers. Work toward unitedcommitment (time, money, staff,resources).

• Clarify and distinguish Health Educa-tion vis-à-vis health promotion andother related professions. Identifypositive and appropriate interface.

• Promote credentialing of professionals.

• Designate health education as a pro-fession within the Bureau of HealthProfessions (definition of legitimateproviders of health services).

• Develop a profile of health educationprofession’s demographics.

• Describe the state of the profession(demographics, area of practice,preparation, and salary).

• Nurture health educators for elected,appointed office, locally and nation-ally.

◆ one goal had four professional organiza-tions working on:

• Arrange for third party payment forhealth education.

◆ four goals have three professional organi-zations working on:

• Coalesce health education groups andassociations.

• Improve and strengthen credentialingbeyond current entry-levelcredentialing and provide specializa-tion.

• Enhance the knowledge and meaningof health education professionals-(generic, role delineation, programframework, commonality across sites).

• Recognize health education as anacademic discipline.

◆ two goals have two professional organiza-tions working on:

• Break down the “camps” (MS, MPH,DrPH, PhD), increasing permeability.

• Require credentialing nationally topractice.


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• Provide a description of the body of knowledge of health education

• Educate employers about the profession of health education

• Establish an understanding of marketing within the profession: promote who andwhat we are, the services we provide, and the outcomes of these services

• Use a focused message for public relations, marketing about field and profession

• Establish criteria of health education impact for products, social policies (usedin marketing, decision making)

• Enhance the profession, its accomplishments, its benefit, and the value ofprevention over the cost of health care

• Connect with consumers and the media (e.g., Consumer Reports, Rodale Press,Reader’s Digest, TV magazines, Consumer Research in the Public Interest, Food& Drug Administration, publishing boards)

• Educate media and corporations about profession (for recognition, used in decisionmaking)

• Provide pre-service and in-service training to other health professionals regardinghealth education

• Develop a cadre of health educators to consult with media

• Establish health education contacts with the media

◆ one goal had one professionalorganization working on:

• Establish national job clearinghouse.

◆ one goal had no professionalorganization working on:

• Develop a unified professionalassociation with staff and advocacy.

External Actions/GoalsMany of the external actions/goals requireactions within the profession. Therefore, anassumption may be made that, for externalactions/goals to occur, the health educa-tion profession needs to initiate action vs.waiting for those outside either professionto act.

Promoting the profession external to theprofession requires working with agencies

and individuals not necessarily associatedwith health education. Of the 41 actions, 7have been or are currently being addressedby one of more organizations. Two actionsare not being addressed by any professionalorganization (promote health educatorsbeing employed by recreation for vacationplaces, and promote the link betweenunknown programs). Seven of the 41 ac-tions identified are being addressed byvarious professional organizations.

◆Educate employers about the professionof health education.

Taking the lead from a state health educa-tion organization, two brochures are beingdeveloped (“Why Hire a Health Educator”and “Why Become a Health Educator”) andwill be shared with other professionalorganizations.


Promoting the Profession - External Actions/Goals


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• Increase health educators’ access to media (own cable channel, nationwide radioshow in many languages and appropriate for many cultures)

• Establish recognition by key publics of trained health education spokespersons

• Identify well-known public spokespersons who speak out and support healtheducation (national-macro, local-micro)

• Establish partnerships with key leaders and power brokers at key sites (govern-ment, universities, business)

• Increase dissemination of information from organizations to users (Centers forDisease Control and Prevention, National Cancer Institute, National Health Lungand Blood Institute)

• Describe the current state of the profession

• Become listed in health manpower directory of health professions

• Become included in surveys regarding professions

• Encourage state, local employers to hire health educators for health education jobs(e.g., Certified Health Education Specialist in job descriptions)

• Initiate legislation and funding that require credentialed health educators to fillhealth education positions

• Encourage other professionals to look to health education for consultation, trainingand professional preparation on health education practice

• Receive reimbursement for health educators’ services

• Create role of health education in managed care (ombudsman)

• Organize coalitions in community to shape managed care

• Establish a national/state health education day/week/year

• Build coalitions and partnerships, networking-interpersonal relations

• Create connections between health education departments and other departmentswithin corporations and agencies

• Include international development teams for health education (Centers for DiseaseControl & Prevention, World Health Organization, World Bank, American Associa-tion of University Women, PSR, NCJW.)

• Establish linkages with other allied health programs

• Become a partner with other health care providers to make an impact on insuranceproviders regarding prevention

• Establish a connection within businesses, integration with Occupational Healthand Safety

• Offer Employee Assistance Programs and employee health promotion programs

• Promote the link between worksite programs (WELCOA, insurance benefits,Washington Business Group on Health, Schools of Business and Economics)


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◆ Establish a national/state health educa-tion day/week/year.

The third week of October has been desig-nated as Health Education Week. Severalorganizations have worked with the privatesector and governmental agencies toproduce and provide promotional kitsfor health educators to use in promotinghealth education week. Some of the materi-als are available on the Internet. PublicHealth week is identified as the first weekin April.

◆ Encourage state and local employers tohire health educators for health educa-tion positions.

In 1998, Arkansas passed state legislationrequiring a Certified Health EducationSpecialist (CHES) to be hired for anystate or local health education position ina public health agency. Other states aremoving toward similar policies that ensurequalified health educators in school, com-munity, health care, and work site settings.

No national health education organizationsare addressing two of the actions/ goals:

◆ Promote health educators being em-ployed by recreation and vacation places.

◆ Promote the link between worksiteprograms.

Of the remaining 32 goals, many organiza-tions either supported but were unable towork on or were willing to work collabora-tively with other organizations. Examples ofthese goals included:

◆ Increase health educators’ access tomedia.

◆ Connect consumers with the media.

◆ Provide health education consultationfor museums, theme parks, and vacationplaces.

Although there were 2 goals on which noorganizations were currently working orwere willing to take the lead does notnecessarily indicate the lack of importanceof these goals. Maybe at this time withinthe individual organizations (and profes-sions), other goals were considered ofgreater importance and therefore weregiven priority within each organization.

Future ActionsPromoting the profession involves advocat-ing for the employment and promotion ofprofessionally prepared individuals to fillhealth education positions. It involvespromoting health education not only withinthe profession but promoting to those


• Work with unions and labor force in general so that reasons for and benefitsof health education services are understood (create demand on behalf of theconstituency)

• Seek partnerships with beneficiaries of health education service

• Establish a consumer focus: health education booth in malls-advice, healtheducation messages on computer shopping networks

• Provide health education consultation for museums, theme parks, interactivedisplays

• Promote health educators being employed by recreation and vacation places

• Establish health education partnerships with gerontology

• Think like a competitor


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external to the profession including regula-tory agencies, third party payers, and thegeneral public.

Health education organizations have takenan active role in promoting health educa-tion within the profession by such actionsas establishing a Code of Ethics, gettinghealth education designated as a professionwithin the Bureau of Health Professions,and strengthening the CNHEO communica-tion network. However, based upon theexternal actions/goals, the professionalorganizations have not been as active pro-moting the profession outside the profes-sion. There could be several reasons forthis. First, the professional organizationsmay have felt it most important to accom-plish key goals within the profession firstprior to promoting the profession exter-nally. Second, it may be that the externalactions/ goals originally developed areconfusing, many overlap and are redundantand really did not provide guidance to theprofessional organizations. Because of this,many organizations may have had difficultyin accurately depicting their role in promot-ing the profession externally.

External actions/goals for promoting theprofession need to be reevaluated to elimi-nate some, clarify others, and removeduplication. Are the actions/goals appropri-ately placed in the internal or externalaction/goals area? For example, “Providea description of the body of knowledge ofhealth education” is placed in the externalaction/goals. Should it be placed underinternal actions/goals, as this is an actionthat the profession itself needs to do, sothat those outside the profession betterunderstand us? Or, “Describe the currentstate of the profession,” which should beconsidered an internal action and, oncecompleted, shared with external constitu-ents to provide a better understanding ofthe profession?

The following ideas would be of value forthe profession:

More clearly define the role of health educa-tion and how the profession fits withinsociety and how we can better work withinthe health care system and society as awhole.

For the public at large, more clearly definethe role of the health educator outside thetraditional settings (i.e., school, healthdepartment). This will provide a perspectiveof health education and how health educa-tion uses a prevention model vs. a medicalmodel.

Assist the profession to move beyond themedical model of health care to a health-focused model of health care, promotinghealth through education, prevention,and reduction of health problems anddisparities.



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Dynamic/Contemporary Practice

DefinitionDynamic/contemporary practice in healtheducation uses advances in many areas ofsociety, including but not limited to com-munication, technology, educational theory,community dynamics, and understandingof human genetics. Quality practice andresearch applies state-of-the-art theory andtechnology in the design, implementation,and evaluation of health education pro-grams.

Dynamic/contemporary practice takes intoaccount and reflects changing communitydemographics, technology, organizationaland marketing strategies, educationalprocesses, and environmental factors. Itrelies upon effective continuing professionaldevelopment that is based on a plannedprogram, sound educational principles, andcurrent and projected workforce needs, andflexibility to adapt to changing needs.

IntroductionDynamic/contemporary practice in healtheducation addresses issues tangential tothe present state of the profession. It fo-cuses on changes within communication,technology, educational theory, authenticmethods, community dynamics, and hu-man biology. To stay current and relevant,health education programs need to reflectchanges in various work settings throughtheir choice of materials, resources, tech-nology, organizational and marketing strat-egies, and educational processes.

Internal Action/GoalsIn 1995, representatives of the healtheducation professional organizations identi-fied six internal actions/goals for movingthe profession toward dynamic and con-temporary practices for the 21st Century.


• Establish a health education home page on the Internet

• Establish a technology clearinghouse

• Disseminate practice strategies within, between, and among professionalassociations and practitioners

• Encourage health education organizations to utilize emerging technology

• Use of contemporary technology and methodology

• Establish a resource clearing house

Dynamic/Contemporary Practice - Internal Actions/Goals


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One or more of the health education organi-zations are addressing or willing to supportwork on three of these six internal actions/goals.

◆ Use contemporary technology and meth-odology.

◆ Encourage health education organiza-tions to utilize emerging technology.

All the health education organizations areusing new technologies such as Power Pointpresentations, Internet connections andwebsites during their annual meetings andat conferences. ASHA’s summer instituteincludes a block devoted to the use ofinstructional technology. The organizations’websites include vital information forhealth professionals, about conferencepresentations, and for consumers often inthe form of health factsheets. APHA–PHEHP created a special interest group toenhance the capacity of those working inhealth communications to stimulate publicsupport for public health education. InNovember 1999, SOPHE digitized portionsof its 50th Anniversary Annual Meeting andplaced it on its website to expand continu-ing education opportunities for practitio-ners. ASHA has a listserve for its members.A private listserve, HEDIR, serves thehealth education profession. Most organi-zations are working to expand their tech-nology.

◆ Disseminate practice strategies within,between, and among professional asso-ciations and practitioners.

Several organizations are currently usingtheir journals or creating supplementalpublications to meet this action/goal. TheJournal of School Health, the Journal ofHealth Education, and the newly initiatedHealth Promotion Practice provide strategiesfor practitioners. APHA-SHES instituted apractitioners’ forum at the 2000 annualmeeting. SSDHPER and ASTDHPPHEindividually and jointly provide technical

assistance to interested state educationand health agencies that do not receiveCDC funding for an infrastructure thatsupports school health programs, includinghealth education.

No health education organizations areaddressing the remaining three actions/goals.

◆ Establish a health education home pageon the Internet.

Although each organization has its ownhome page, no home page exists for theprofession. A home page could highlight thesubstance of the profession.

◆ Establish a technology clearinghouse.

◆ Establish a resources clearinghouse.

The absence of health education organiza-tions’ involvement in these two actions/goals is less a lack of validation for suchefforts than a reflection that they are notdeemed priorities of the organizations.

External Actions/GoalsParticipants at the 1995 meeting identifiednine actions/goals that involve people,groups, or organizations outside the profes-sion to move the health education profes-sion toward dynamic and contemporarypractices in the 21st Century.



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• Develop and/or adapt technology to disseminate health information, healthdiscovery

• Establish a nonprofit foundation for health education technology and marketing

• Link consultants to companies developing products

• Link services and programs to health education classes

• Foster community vision that health promotion is their concern/ issue

• Encourage participation of health educators in community-wide health promotioneducation planning, implementation, and evaluation

• Recruit health educators for community health promotion/ education projects/initiatives

• Recruit minorities/diverse students into the profession

• Establish Employees/employer assistance programs and work site health promotion

Dynamic/Contemporary Practice - External Actions/Goals

Because these goals relate to actions neces-sary external to the profession, the in-tended audience in some cases is not thehealth education professional but the laypublic.

Four external actions/goals have threeor more health education organizationsalready working or willing to collaborateon them.

◆ Develop and/or adapt technology todisseminate health information, healthdiscovery.

Some organizations use portions of theirweb sites to disseminate health informationand/or health discovery to the generalpublic and other professionals who arenot part of their organization.

◆ Foster community vision that healtheducation/promotion is their concern/issue.

◆ Encourage participation of healtheducators in community-wide healtheducation/promotion planning, imple-mentation, and evaluation.

Although interest has been expressed, noprofessional organizations are currentlyworking on the aforementioned actions.This will require development and imple-mentation of a strategy for marketing theprofession. The intent of this strategyshould be creating and communicating avision of the possibilities health education/promotion provides (i.e., prevention andmitigation of illness, enhanced quality oflife).

◆ Recruit minorities/diverse students intothe profession.

For the past four years, AAHE has activelyrecruited minorities by developing a Minor-ity Involvement Committee that becamea Multicultural Involvement Committee.Activities include programming at its an-nual convention focused on minority issuesand working with Historically BlackColleges and Universities as well as His-panic Serving Institutions as part of itscooperative agreement with CDC. APHA-SHES recruits minority students to enterthe profession through its members who



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work in public schools encouraging theirstudents to enter the profession. SOPHE’sOpen Society Commission is addressingoutreach and leadership developmentopportunities for minorities in the profes-sion.

No professional organizations are address-ing four of the external actions/goals thatsupport dynamic and contemporary prac-tices. Perhaps the scope of these goals isoutside the purview of professional organi-zation.

◆ Recruit health educators for communityhealth education/promotion projectsand initiatives.

◆ Establish a nonprofit foundation forhealth education/promotion technologyand marketing.

The Comprehensive Health EducationFoundation (C.H.E.F.) provides an exampleof such a foundation. However, no healtheducation membership organization hasplans to establish such a foundation.

◆ Link consultants to companies develop-ing products.

Many individual health educators alreadyserve as consultants to and in some casesown or operate companies that develophealth education-related products. Mem-bership organizations, however, are cau-tious about linking members to commercialventures for fear of appearing to providea financial advantage to some membersover others.

◆ Establish employee assistance andwork site health promotion programs.

ASHA promotes employee wellness pro-grams in schools, especially through thework of their Director of ProfessionalDevelopment. The efficacy of work sitehealth promotion should be marketed tocompany wellness programs, personneldirectors, and unions. SOPHE’s worksite

health special interest group serves as anongoing forum to address worksite wellnessissues. SOPHE also cosponsored a meetingwith the National Institute for OccupationalHealth and Safety (NIOSH) in 1999 toaddress worksite safety and training.

Future ActionsThe national health education organiza-tions are using new technologies and pro-viding models, encouragement, and train-ing for professionals interested in stayingcurrent. They often follow, rather than set,trends.

Actions national organizations could taketo help professionals stay dynamic andcontemporary in their practice include:

• Create a program similar to the Ameri-can Psychological Association’s Behav-ioral and Social Science VolunteerProgram (BSSVP) that provides con-sultants to community planninggroups using funding from CDC.

• Increase linkages to minority organiza-tions to attract increasingly diversepeople to the health education profes-sion.

• Use systems of communication andinformation exchange that take advan-tage of electronic advancements(web-based reporting systems, regis-trations, activity tracking, informationretrieval).

• Establish a home page for the profes-sion of health education which wouldinclude a listing of the CNHEO organi-zations, the Code of Ethics, definitionswithin the profession, and programsthat have SABPAC approval. Withinthe listing individual users couldreach home pages of the organiza-tions.


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The 1995 meeting cosponsored by theNational Commission for Health EducationCredentialing and the Coalition of NationalHealth Education Organizations initiatedthe work on actions and goals which wouldmore firmly establish the profession ofHealth Education. Much work remains tobe done, on many levels, and, to a certainextent, by everyone in the health educationprofession as well as by external partners.Working on this report has created a pro-cess over the past five years for collabora-tion and communication among the na-tional health education organizations. It isexpected that this spirit of cooperation willcontinue and flourish.

What remains to be done?Several important action steps have beenachieved, including acceptance of a Codeof Ethics for the profession and the inclu-sion of the term “health educator” into theDepartment of Labor’s standard occupa-tional classification system. Progresscontinues for many of the other suggestedactions.

The CNHEO plans to convene a meeting inthe near future to discuss the actions thathave not been addressed by the healtheducation organizations, and why CNHEOis also expected to provide leadership intracking the progress of these action steps.Some actions are unclear, others redun-dant, and others irrelevant at this time.Some actions are more important thanothers and need to be prioritized. Thisprocess also needs a proposed timelineand recognition of external partnerships.Health education leaders need to articulateand disseminate the best practices ofhealth education. We need to evaluate theachievement of these goals and to identifyother important areas of the professionbeyond these six focal points.

The following focal points are defined andcontain salient recommendations for futureaction.

Professional PreparationProfessional preparation is the academiccoursework and associated fieldworkrequired of students to receive a degree inhealth education. Colleges and universitiesoffer professional preparation for healtheducators at the baccalaureate, masters,and doctoral levels. Health education pro-fessional preparation programs have aresponsibility to provide quality educationto their students, thus benefiting both theprofession and the public. Such qualityeducation derives from and develops instudents key responsibilities and compe-tencies defined by the profession at boththe entry and advanced levels. Many pro-grams also offer specific courses for thosepreparing to work in various settings (e.g.community/ public health, schools, medi-cal care, or the workplace). Formal accredi-tation mechanisms help ensure the qualityof professional preparation programs.

Individuals who take and pass the certifiedhealth education specialist (CHES) exami-nation after they complete their degreework demonstrate their competence inmeeting the responsibilities and competen-cies expected of entry-level health educa-tors. The National Commission on HealthEducation Credentialing (NCHEC) hasresponsibility for developing and adminis-tering these examinations. The Commissionand its network of continuing educationproviders also approve continuing educa-tion offerings for credit toward periodicrecertification.

◆ Assure awareness by professional prepa-ration programs of the new standards forprofessional preparation being developedby NCATE and of the CompetenciesUpdate Project.

CONCLUSIONS AND RECOMMENDATIONS

Conclusion and Recommendations

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◆ Encourage all health education profes-sional organizations to have mentoringprograms for students.

◆ Carefully consider the possibility ofstandardizing accreditation of profes-sional preparation programs in healtheducation.

◆ Expect professional preparation pro-grams to effectively prepare their stu-dents to sit for the CHES examination.

◆ Continue and strengthen efforts to at-tract individuals of diverse ethnicityto the profession of health education.

◆ Expect health education organizationsto partner with diverse organizationsin order to develop policies that willenhance the health of the public.

Quality AssuranceQuality assurance in health educationrefers to professional accountability inconforming to established standards andcriteria in health education. A dynamichealth education profession requiresperiodic review and revision of standards,consistent with new findings in research,theory and practice. Examples of qualityassurance in health education includecertification of individuals, the accredita-tion and/or approval of professional prepa-ration programs in health education, andthe application of health education ethicalstandards.

◆ Strengthen quality improvement mecha-nisms for health education.

◆ Articulate standards for professionalperformance in areas external to theprofession.

◆ Establish standards related to outcomes.

◆ Consider requiring credentialing nation-ally to practice, specifiy CHES in jobdescriptions.

◆ Include health education competenciesin standardized assessments.

◆ Develop and adopt model standards forhealth education programs.

◆ Publicize the Code of Ethics.

ResearchHealth education research is both appliedand basic. It draws from theoretical con-structs found in educational, social, behav-ioral, and life sciences. Health educationtheory and research derives from anduses rigorous social science methods. Theknowledge derived from this research formsthe basis of the practice of health educa-tion. Health educators apply these con-structs to improve individual and popula-tion based health. The practice of healtheducation, in turn, influences health edu-cation theory and research.

◆ Improve communication of researchfindings internally and externally andcreate health education programs andinterventions based on sound theory anddemonstrated methods and strategies.

◆ Urge and support health educatorsto become more adept at documentingsuccess through evidence-basedresearch that demonstrates efficacyand effectiveness.

◆ Increase research in order to strengthenthe efficacy of the profession.

◆ Increase availability of monies forresearch.

◆ Expect health educators to work moreclosely with Prevention Research Centers(public and private) to disseminatecutting-edge community-based healtheducation research.

◆ Encourage national organizations andtheir constituents to incorporate re-search and scholarly activity in all theirprofessional activity, when appropriate.

Conclusions and Recommendations

51

AdvocacyHealth educators, professional associa-tions, professional preparation programs,and public and private health educationorganizations play a major role in the devel-opment, diffusion, and evaluation of poli-cies that influence health. The World HealthOrganization defines advocacy for healthas “a combination of individual and socialactions designed to gain political commit-ment, policy support, social acceptance,and systems for a particular health goalor program.” The goal of advocacy effortsis to arouse public concern and mobilizeresources and forces in support of an issue,policy or constituency.

◆ Continue and expand strategies forsystematic, collaborative advocacy train-ing of health education professionals.

◆ Continue to identify priority advocacyissues collaboratively, developing andsharing fact sheets and advocacy alerts.

◆ Work through other state and nationalcoalitions to support and promote theprofession of health education as wellas health education initiatives.

◆ Expect professional preparation pro-grams to integrate teaching advocacyissues and skills into their curricula.

◆ Develop a system for sharing and build-ing on existing advocacy efforts andprogress in order to clarify andstrengthen the unified voice of healtheducation, and to recognize the effortsof others on issues of importance tohealth education.

◆ Develop long-term plans to continueto influence decision makers, and toprepare, encourage, and support healtheducators to position themselves throughappointments and elections as the actualdecision makers.

Promoting the ProfessionPromoting the profession involves advocat-ing for the employment and promotion ofprofessionally prepared, qualified individu-als to fill health education positions. It alsoinvolves informing employers, third partypayers, governmental regulatory and fund-ing agencies, and the public at large aboutthe skills and competencies of practicinghealth educators.

◆ Promoting the profession involves advo-cating for the employment and promo-tion of professionally prepared individu-als to fill health education positions.It involves promoting health educationnot only within the profession but pro-moting to those external to the profes-sion including regulatory agencies, thirdparty payers, and the general public.

◆ External actions/goals for promotingthe profession need to be reevaluatedto eliminate some, clarity others, andremove duplication.

◆ More clearly define the role of healtheducation and how the profession fitswithin society and health care.

◆ For the public at large, more clearlydefine the role of the health educatoroutside the traditional settings (i.e.,school, health department).

◆ Assist the profession to move beyondthe medical model of health care to ahealth-focused model of health care.


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Dynamic/Contemporary PracticeDynamic/contemporary practice in healtheducation uses advances in many areasof society, including but not limited tocommunication, technology, educationaltheory, community dynamics, and under-standing of human genetics. Qualitypractice and research applies state-of-the-art theory and technology in thedesign, implementation, and evaluationof health education programs.

Dynamic/contemporary practice takesinto account and reflects changing com-munity demographics, technology, organi-zational and marketing strategies, educa-tional processes, and environmentalfactors. It relies upon effective continuingprofessional development that is basedon a planned program, sound educationalprinciples, and current and projectedworkforce needs, and flexibility to adaptto changing needs.

◆ Create a program similar to theAmerican Psychological Association’sBehavioral and Social Science Volun-teer Program (BSSVP) that providesconsultants to community planninggroups.

◆ Increase linkages to minority organiza-tions, such as the NAACP, to attractincreasingly diverse people to thehealth education profession.

◆ Use systems of communication andinformation exchange that take advan-tage of electronic advancements (web-based reporting systems, registrations,activity tracking, information retrieval).

◆ Establish a more permanent website forthe profession of health education thatwould include a listing of the CNHEOorganizations and links to the websitesof other health education organizations.

The Future InvolvementHealth educators have an important role inadvancing the profession. National healtheducation organizations and associationswill continue to address the action stepslisted in this report on an ongoing basis.As a member of these organizations,participate and support these efforts instrategic planning; in developing papers,publications and conference presentations;and in activity at the state and local level.Communication is vital among colleaguesand allied professions.

However, many suggested actions arebeyond the scope of a national healtheducation organization. It may requireaction by individual practitioners, prepara-tion programs in academic settings, orlegislation at the state or national level.Look at what can be addressed in your ownroles. Be a catalyst for suggesting actionsby asking questions, building partnershipsand sharing ideas and information basedon these focal points. Find opportunities totake responsibility and leadership.

What’s next?◆ Reading and discussing this report will

help make these ideas become real.Talk about what’s possible in the work-place, and with your alma mater, yourorganization, and your state. Identifywho and what else is needed to makethese suggested actions happen.

◆ Be receptive to changes in the profes-sion. Be alert to and plan for legislativeinitiatives, and how they affect thehealth of the public and the strengthof the profession.

◆ Write articles about what is being doneto achieve these action goals.


53

◆ Impediments remain for integratingthese concepts into curricula, accredita-tion standards, legislation, and work-place policies. Health educators arechallenged to think more broadly thantheir immediate job, more deeply thanindividual needs.

◆ Expect results from our leaders, ourcolleagues and ourselves. There’s impor-tant work for all to do—and no one willdo it for us. We have a responsibilityto those who came before us, to theprofession of health education, and tothe public. The potential for health edu-cation to become part of the foundationfor health care is a vision whose timehas come.


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Welcome to the future of Health Education!This document helps us to see the possibili-ties we face in the 21st century. It helps usput into perspective the responsibility wehave as organizations and individuals tosee the vision of the profession of HealthEducation and to make choices for itsfuture.

The six focal points have provided us withdirection:

• Promoting the Profession

• Research

• Advocacy

• Professional Preparation

• Quality Assurance

• Dynamic/Contemporary Practice

We have initiated actions within theorganizations in these focal points and,as a result, there has been a coalescingof activities. Actions have resulted thatillustrate we are moving to strengthen theprofession. It is an ongoing process andwill take time before we will be recognizedand accepted by the public as one of theprofessions essential to health and wellbeing. It can and will happen if each of uswithin our sphere of professional function-ing continues to see the vision of what canbe. Perhaps by the year 2020 we will see:

• Health education as the base of healthcare in the U.S.

• CHES certification required for allpracticing health educators.

• Insurance companies reducing feeswhen customers provide evidence ofhealth literacy.

• Health educators in practice withphysicians.

• Health educators as members of theteam in hospitals, clinics, business,and industry.

• Health education required as one of thebasic subjects for preschool throughgrade 12.

• Health education required as one of thegeneral education courses in all collegesand universities.

• Health education accepted as an avail-able program for employees in businessand industry.

• Health educators represented in anadvisory and problem-solving capacitywithin community structures and legisla-tive bodies.

• Health education accepted as an essen-tial program in religious institutions.

• Health education accepted as an avail-able program in retirement communitiesand assisted living centers.

• Health educators viewing the practiceof the profession holistically:

4nurturing clients from existing healthproblems toward health;

4educating for the prevention of everchanging problems in health towarda status of living healthfully; and

4educating toward establishing qualityin living.

• Annually summarizing and reportingresearch in health education in all prac-tice areas as well as basic research.

• A website established for the professionof health education containing:

4outcomes of health education forthe public,

4definition of a health educator,

4connection to websites of all ofthe organizations belonging to theCoalition of National Health EducationOrganizations,

AFTERWORD

Afterword

56

4 location of all professional preparationinstitutions for health educators,

4code of ethics of the health educationprofession,

4benefits of health literacy,

4connection to a web site for healtheducation in each state and territoryin the USA, and

4advocacy alerts and organizationalresolutions/policy statements.

The task before the profession is to use thisdocument as a “work in progress,” to refineit and build direction for the profession andits practitioners. It becomes a continuingprocess: hourly, daily, weekly, monthly,and annually. It becomes the mantle thateach student, practitioner, professionalprogram, and professional organization hasa choice of shouldering with the awarenessthat by making a positive choice the futurefor health education can move from restor-ative and preventative closer to a futurestrong in manifesting quality in life andliving.

See the vision—dream the dream!

Ann E. Nolte, Ph.D., CHESDistinguished Professor, emeritaIllinois State UniversityConsultant, Health Education for the 21st

Century

Afterword

57

In 1995, representatives of 10 nationalhealth education organizations* met toconsider actions needed to address currentand emerging challenges to the healtheducation profession. Since that time, therepresentatives have used conference callsand email to identify the actions eachorganization is taking and would be willingto take to move the profession forward inways suggested at the 1995 forum. Thisprogress report summarizes activities ofthe 10 organizations from 1995 through1999. It does not include activities of indi-vidual health educators or of groups ofhealth educators working at the local,regional, or state levels.

The original report proposed 163 actionsin six domains: professional preparation,quality assurance, research, dynamic/contemporary practice, advocacy, andpromoting the profession. Each domaindistinguished actions that health educators(or their organizations) could take fromthose that people or institutions outsidethe profession would need to accomplish.

Based on the organizational assessment,the representatives concluded that the ninenational organizations are addressing orhave accomplished the majority of theproposed actions in some manner. In afew instances, only one organization isworking on a specific action; more com-monly, several groups are addressing aparticular action, either independentlyor collaboratively.

EXECUTIVE SUMMARYProgress Report 1995-2000

The national organizations collectivelyhave made particular progress on boththe internal and external actions relatedto professional preparation and advocacy.Noteworthy accomplishments includeincreased education of practitioners andfaculty about emerging technology, morehealth educators seeking CHES credential-ing, use of profession-wide competenciesfor accreditation of professional preparationprograms, some employers requiring aCHES credential for employment as ahealth educator, and recognition of “healtheducator” as a distinct occupation by theU.S. Department of Labor. A significantoutgrowth of the 21st Century initiativeis an annual Health Education AdvocacySummit cosponsored by most of the partici-pating organizations. The Summit usesbriefing papers developed in advance toensure that the organizations speak witha common voice and includes advocacytraining followed by meetings with federallegislators or their aides to advocate forhealth education programs, policies, andfunding.

The national organizations have also madesubstantial progress on internal actionsrelated to quality assurance, research, anddynamic/contemporary practice. Especiallynoteworthy is the adoption of a single codeof ethics for the health education profes-sion, which is an action that crosscutsseveral of these domains. The organizationshave accomplished less on external actionsrelated to quality assurance, research, anddynamic/contemporary practice. Moreremains to be done in promoting the pro-fession (internal and external actions) and

*American Association for Health Education; American College Health Association; American Public Health Association(Public Health Education & Health Promotion Section and School Health Education & Services Section); American SchoolHealth Association; Association of State and Territorial Directors of Health Promotion and Public Health Education;Coalition of National Health Education Organizations; Eta Sigma Gamma; National Commission for Health EducationCredentialing, Inc.; Society for Public Health Education, Inc.; and Society of State Directors of Health, Physical Educationand Recreation.

Executive Summary

58

dynamic/ contemporary practice (internalactions), although some efforts have beeninitiated since 1995.

The 21st Century initiative of organizationalsharing has strengthened the collaborationof the national organizations through theCoalition of National Health EducationOrganizations (CNHEO). Through the pro-cess, representatives identified and imple-mented new avenues for collective actionor sharing resources. In addition, many ofthe participating national organizationshave adopted strategic plans that reflectone of more of the six domains identifiedat the 1995 forum.

The work of moving the profession forwardin a more systematic, coordinated fashionis far from complete. CNHEO can provideleadership for continued collaboration byperiodically convening representatives ofthe national organizations to updateprogress in accomplishing the suggestedactions; identifying actions no organizationis addressing and suggesting ways to moveforward on those actions; and identifyingemerging challenges that require newactions. In addition, it is hoped that healtheducators individually and collectively atthe local, state, and regional levels willuse this report to identify ways they cancontribute to advancing the profession.All health educators have a role to play inensuring quality programs and improvingrecognition, resources, and support forthe profession so that, ultimately, healtheducation can contribute its full potentialof improving the health of the public.

Executive Summary

59

PublicationsAmerican Association for Health Education,

National Commission for HealthEducation Credentialing, Societyfor Public Health Education. ACompetency Based Framework forGraduate-Level Health Educators.Allentown, PA: National Commissionfor Health Education Credentialing,1999.

Doyle, E.I., & Cissell, W.B. (1998). Acritical analysis of the CHEScredentialing issue: Bridging thegap between vision and outcomes.Journal of Health Education, 29 (4),213-220.

Clark, J. K., Wood, M.L., & Parrillo, A.V.(1998). Where public health educa-tors are working: A national study ofthe hiring practices and manpowerneeds of local health departments.Journal of Health Education, 29(4),250-257.

Clark, J. K., Parrillo, A.V., Wood, M.L.(1998). Attitudes and perceptionsabout health education credential-ing: A national study of top agencyexecutives in local health depart-ments. Journal of Health Education,29(4), 244-249.

Colquhon, D., & Kellehear, A. (Eds.). (1993).Health research in practice: Political,ethical and methodological issues.New York: Chapman & Hall.

Duryea, E. J. (1999). Policy, theory andsocial issues—Meta-Review of sam-pling dilemmas in health educationresearch: Design issues and ethicalprecepts. International Quarterly ofCommunity Health Education, 19(2),145-163.

Gielen, A.C., McDonald, E.M., & Auld,M.E. Health Education in the 21st

Century: A White Paper. Rockville,MD: U.S. Department of Health andHuman Services, Health Resources& Services Administration, 1997.

Joint Committee on National Health Educa-tion Standards, National HealthEducation Standards: AchievingHealth Literacy. Atlanta, GA: Ameri-can Cancer Society, 1995.

National Commission for Health EducationCredentialing, Inc., American Asso-ciation for Health Education, and theSociety for Public Health Education.(1999). A Competency-Based Frame-work for Graduate Level HealthEducators. Allentown, PA: NationalCommission for Health EducationCredentialing.

National Commission for Health EducationCredentialing, Inc. (1996). A Compe-tency-Based Framework for Profes-sional Development of CertifiedHealth Education Specialists. Allen-town, PA: National Commission forHealth Education Credentialing.

O’Rourke, T.W., Schwartz, L.W., & EddyJ.M. (1997). Report on the use andimpact of the competencies for entry-level health educators and willing-ness to be included in a registry ofprograms using the competencies.Champaign, IL: Department of Com-munity Health, University of Illinois.

Pigg, R.M. (Ed.). (1994). Ethical issues ofscientific inquiry in health scienceeducation. The Eta Sigma GammaMonograph Series, 12(2).

Report of the 1990 Joint Committee onHealth Education Terminology,Journal of Health Education 22(2),1991.

REFERENCES

References

60

Sciacca, J., Neiger, B., Poindexeter, P.,Hubbard, B., Giles, R., Black, D.R.,Barr, H., Middleton, K., Cosgrove,W., & Cleary, M. (1999). Perfor-mance on the CHES Examination:Implications for institutions offeringprograms in health education.Journal of Health Education, 30(1),42-46.

Society for Public Health Education, Asso-ciation for the Advancement ofHealth Education BaccalaureateProgram Approval Committee(SABPAC). Manual on BaccalaureateHealth Education Program Approval;Criteria and Guidelines for Self-Study. Washington, DC, October 19,1990.

South, J., & Tilford, S. (2000). Perceptionsof research and evaluation in healthpromotion practice and influences onactivity. Health Education Research,15(6), 729-743.

The Health Education Profession in theTwenty-First Century: Setting theStage, Journal of Health Education,27(6), 357-364, 1996.

Internet ResourcesAmerican Educational ResearchAssociation1230 17th Street, NWWashington, DC 20036Phone: 202/223-9485Fax: 202/775-1824www.aera.net

Bureau of Health Professionswww.bhpr.hrsa.gov

Coalition of National Health EducationOrganizationshttp:www.hsc.usf.edu1~kmbrown/CNHEO.htm

Comprehensive Health EducationFoundation22419 Pacific Highway SSeattle, WA 98198Phone: 800/323-2433Fax: 206/824-3072www.chef.org

Council on Education for Public Health800 Eye Street NW, Suite 202Washington, DC 20001-3710Phone: 202/789-1050Fax: 202/789-1895www.ceph.org

Essential Public Health Serviceswww.phf.org/essential.htm

Health Education Brochureswww.med.usf.edu/~kmbrown/CNHEO.htm

Health Resources and ServicesAdministrationwww.hrsa.gov

Healthy People 2010www.health.gov/healthypeople

Hispanic Serving Institutionswww.ed.gov/offices/OIIA/Hispanic/hsi

Historically Black Colleges andUniversitieswww.nafeo.org

National Association for the Advance-ment of Colored People4805 Mt. Hope DriveBaltimore, MD 21215Phone (hotline): 410/521-4939www.naacp.org

References

61

National Association for EqualOpportunity in Higher EducationHBCU8701 Georgia Avenue, Suite 200Silver Springs, MD 20910Phone: 650-2440Fax: 310/495-3306www.nafeo.org

National Center for Injury Preventionand ControlMailstop K654770 Buford Highway NEAtlanta, GA 30341-3724Phone: 770/488-1506Fax: 770/488-1667www.cdc.gov/ncipc

National Commission for HealthEducation CredentialingPhone: 888/NCHEC4

National Council on Accreditationof Teacher Education2010 Massachusetts Avenue NWWashington, DC 20036-1023Phone: 202/466-7496Fax: 202/296-6620www.ncate.org

The Robert Wood Johnson FoundationCollege Road East & Route 1,P.O. Box 2316Princeton, NJ 08540-2316www.rwjf.org

Tribal Serving Institutions (TSI)www.aihec.org

UCLA School Mental Health Project/Center for Mental Health in [email protected]

References

Emerging Goals for the

Health Education Profession*

Vision Statement

The health education profession promotes, supports, and enables healthylives and communities.

Premises

• The health education profession promotes health literacy and enables and supportshealthy lives and communities.

• Grounded in the values and needs of the community, health education promotessocial and environmental justice.

• Many of the leading causes of morbidity and mortality are behaviorally based.

• Health literacy is an enabling factor in promoting healthy behaviors.

Goals**

The health education profession as a partner in promoting healthy people in a healthyworld:

1. Assures its services are state-of-the-art and based on theory, research, best prac-tice standards, and ethical standards.

2. Assures its research is grounded in theory and based in practice.

3. Plays a role in the development, diffusion implementation, and evaluationof policies that influence health.

4. Incorporates current technology and is contemporary and dynamic.

5. Utilizes appropriate pedagogy.

6. Considers social, cultural, economic, and political influences in promoting health.

7. Promotes social justice.

*The Health Education Profession in the Twenty-first Century: Setting the Stage, Journal of Health Education,27(6), 3, 1996.

**Please note that these are emerging goals. There may be many other goals, but this set is a beginning. Theyare not prioritized.

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