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Health Education and Health Promotion: Key Concepts and Exemplary Evidence to Support Them

• First Online: 09 October 2018

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• Hein de Vries 8 ,
• Stef P. J. Kremers 8 &
• Sonia Lippke 9  

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Health is regarded as the result of an interaction between individual and environmental factors. While health education is the process of educating people about health and how they can influence their health, health promotion targets not only people but also their environments. Promoting health behavior can take place at the micro level (the personal level), the meso level (the organizational level, including e.g. families, schools and worksites) and at the macro level (the (inter)national level, including e.g. governments). Health education is one of the methods used in health promotion, with health promotion extending beyond just health education.

Models and theories that focus on understanding health and health behavior are of key importance for health education and health promotion. Different classes of models and theories can be distinguished, such as planning models, behavioral change models, and diffusion models. Within these models different topics and factors are relevant, ranging from health literacy, attitudes, social influences, self-efficacy, planning, and stages of change to evaluation, implementation, stakeholder involvement, and policy changes. Exemplary health promotion settings are schools, worksites, and healthcare, but also the domains that are involved with policy development. Main health promotion methods can involve a variety of different methods and approaches, such as counseling, brochures, eHealth, stakeholder involvement, consensus meetings, community ownership, panel discussions, and policy development. Because health education and health promotion should be theory- and evidence-based, personalized interventions are recommended to take empirical findings and proven theoretical assumptions into account.

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de Vries, H., Kremers, S.P.J., Lippke, S. (2018). Health Education and Health Promotion: Key Concepts and Exemplary Evidence to Support Them. In: Fisher, E., et al. Principles and Concepts of Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-93826-4_17

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Health Education Intervention Strategies: Recommendations for Future Research

1994, Health Education & Behavior

While the ultimate goal of health education interventions is to positively influence health status, more proximal indicators of success are changes in intermediate outcomes, or impact. Because health education interventions work through intermediate outcomes, the linkage to health status is often assumed to be at a conceptual or theoretical level. The term health education intervention strategy is a heuristic device used to conceptualize and organize a large variety of activities. There is a wide range of studies and reports in the literature that either test specific intervention strategies or report on larger health education efforts combining several strategies. This article organizes the discussion to focus on individual-, community-, and policy-level interventions. Mass communications are also considered, and the authors comment on program planning issues that cut across specific interventions at the individual, community, and policy levels. Eleven recommendations are offered for future health education intervention research.

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Health Education

(16 reviews)

College of the Canyons

Copyright Year: 2018

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Reviewed by April Parrott, Instructor, Lane Community College on 8/15/24

Covers all major topics well. I believe the section on cardiovascular disease should contain information on early heart attack detection and what to do, and BEFAST for stroke. The psychological health section covers a HUGE array of topics but... read more

Comprehensiveness rating: 5 see less

Covers all major topics well. I believe the section on cardiovascular disease should contain information on early heart attack detection and what to do, and BEFAST for stroke. The psychological health section covers a HUGE array of topics but lacks information about treatment for most disorders. In general, great information on topics but less information on how to manage issues.

Content Accuracy rating: 4

Information feels accurate.

Relevance/Longevity rating: 4

Updates should be easy edits for this textbook but some of the information may not be relevant for long periods of time, specifically the information on marriage and relationships.

Clarity rating: 5

Easy to read. Limited use of hard to understand terminology.

Consistency rating: 5

Very consistent in terms of terminology and framework. Each chapter is laid out similarly to the previous chapter. However, this also means that each chapter is lacking in things like images, charts and graphs.

Modularity rating: 5

This textbook has very logically modulated the chapters and subtopics within those chapters. It would be very easy to direct students to certain blocks of information. I do not recall any self-referential material.

Organization/Structure/Flow rating: 5

Organization is logical and builds upon itself. For example, the chapter on stress management begins by talking about what stress is and its effects on the body then into managing and coping. Chapter 5 introduces gender and sexuality which is immediately followed by sexual health which is followed by sexually transmitted diseases.

Interface rating: 4

There are some headings that are on one page and their text on the next or places where photos cause large gaps on previous pages. It does not have a navigable TOC.

Grammatical Errors rating: 5

Easy to read.

Cultural Relevance rating: 4

I believe the section on Relationships and Communication is slightly dated and could be offensive to some readers as it describes relationships in a this way or that way type of language where it is likely that gender and relationships between genders is more fluid. I think this will date this chapter rather quickly.

In general, the book lacked things that made it interesting to look at. There were few images and they were not all the quality in terms of the breath of information they added. There is a lot of information that would be better presented in charts or tables. There is a general lack of how to turn this knowledge into practice.

Reviewed by Uma Hingorani, Affiliate Professor, Metropolitan State University of Denver on 10/12/23

There is a Table of Contents, but an index and glossary of terms would both be helpful to find information quickly. read more

Comprehensiveness rating: 4 see less

There is a Table of Contents, but an index and glossary of terms would both be helpful to find information quickly.

The information is well organized and accurate. Some updates are needed, such as reference to latest edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM), including online tools to track menstrual cycle and Roe vs. Wade overturned stance on abortion in U.S., using more current CDC Fact sheets, including psychodelic mushrooms under drugs of abuse and impacet of legalization of marijuana on abuse potention, and including e-cigarettes, JUUL, and other modern cigarette types. Some minor typographical and spelling errors were noted ('spermacides').

Updating sections to include modern aspects would be helpful.

The language is clear and conducive to an undergraduate level college audience.

The book flows well and uses consistent terminology throughout the chapters.

The text is divided into subsections, making it manageable to read and understand.

Organization/Structure/Flow rating: 4

The book is well organized and flows well.

Use of more diagrams would be helpful. The diagrams and charts used emphasize the textbook reading.

Grammatical Errors rating: 4

Some minor typographical (bullets points not aligned in e-copy) and spelling errors were noted ('spermacides').

Culturally and racially sensitive.

This is a well-written, well-organized textbook which provides a good overview of health. Including the WHO definition of health and wellness would be beneficial as well as using more references to college-age students to engage this audience. In addition, updating sections to modern times would be helpful. Nonetheless, it is a straightforward and helpful textbook to use for a general health class elective.

Reviewed by Anna Smyth, Adjunct Faculty, Salt Lake Community College on 4/18/21

Health is a broad subject, and this book has done a nice job of categorizing and explaining some of the most important aspects. The book does not have a glossary or index but provides references at the end of each chapter for further exploration. read more

Health is a broad subject, and this book has done a nice job of categorizing and explaining some of the most important aspects. The book does not have a glossary or index but provides references at the end of each chapter for further exploration.

The data and information presented in the book appears to be accurate but some statistics are over 10 years old. Students would benefit from an updated edition. The information about sensitive topics such as violence in relationships, sexual health, etc. are handled skillfully without bias.

The text is written in a way that it would be relatively easy to update. Some of the topics, legal marriage for example, are changing due to legislation across the country, but the book speaks generally enough about these topics to capture this reality. The reader can pursue the references included at the end of each chapter to find more specific time-sensitive data around such topics.

Clarity rating: 4

The book is very clear in its use of language. This is a particularly appealing element if you have students whose native language isn't English. A moderate proficiency in English will make this book accessible--easy to read and understand. One missing piece of context noted: Section 5.6 seems to refer to a chart, ie "in the lower left corner" but no chart is included.

Consistency rating: 4

The text is consistent in the way the framework has been structured and the terminology is relatively consistent throughout, however there are some occasional verb tense inconsistencies, for example in Chapters 6 and 8 the voice alternates between speaking directly to the reader (you) and in third-person.

Modularity rating: 4

It would be as easy to pull a few excerpts from the book as assigned reading as it would be to review the entire text throughout a semester. There could be more of a contextual introduction to each chapter that may help provide a useful modular framework.

As the text is a presentation of a variety of interrelated topics rather than information that must be presented in a particular sequence for full and proper understanding, the organization seemed appropriate and sufficient. As Maslow's heirarchy is presented, there is an argument for using the order from that framework or the order of the six dimensions of health presented in Chapter 1, but the content therein, aside from Chapter 1, is not determined by the sequence so the current organization is sufficient.

I saw no significant interface issues, however the text could benefit from more illustrative images throughout to support learning and such images could help with minimizing any confusion as well as retention of the information presented. An example of such is Figures 14 and 15 on page 152 and Figure 4 in Chapter 9.

In my review, I noticed very few grammatical or spelling errors.

Cultural Relevance rating: 3

Some of the sections could be updated with more inclusive language, such as the section on fertility and conception. Language such as "pregnant people" rather than "pregnant women" or "birthing person" rather than "pregnant mother" is more inclusive of the transgender community. The text generally tends to reference nationwide statistics without detail or context regarding specific demographics. This could be a valuable addition as illustrated in Chapter 1 that health can be substantially influenced by things such as race and ethnicity, culturally sensitive healthcare, sexual identity and orientation, etc. which are topics included later in the text. Expounding upon some of these critical aspects of health and determinants of health would add value and represent a more comprehensive perspective of health in the US.

This book is a solid resource with lots of useful information to use in health-related course curricula.

Reviewed by Garvita Thareja, Assistant Professor, Metropolitan State University of Denver on 3/16/21, updated 4/22/21

It had covered most of the major topics in health and wellness. However, there are some foundational topics like dimensions or health (they touched these, but need more depth), theories for behavior change that should be added , being foundational... read more

It had covered most of the major topics in health and wellness. However, there are some foundational topics like dimensions or health (they touched these, but need more depth), theories for behavior change that should be added , being foundational in nature. Then again, some concepts are just added there and may not be needed at this level as it adds to confusion than contribution. We don't need that deeper biology part as its a health topic and not anatomy/physiology.

Content Accuracy rating: 5

Its very accurate book. I would re structure some aspects and add some examples at few places, but overall, its up the mark with accuracy.

Relevance/Longevity rating: 3

Content needs an update. For example if its a weight management, then we need to add information about various apps and calorie tracking resources. If its a drug and abuse, I would add an activity that really engages students about how taking shots can affect their cognition and possibly put them in DUI. This text has too much theoretical concepts but less of applied part or case studies.

The information is clear and use simple languages. Not big jargons or difficult terms.

Yes, its consistent with the topics and headings and sub headings. Its just too much information actually VS field work, examples and real applications.

yes, its divided into various parts and sub parts. Easy to navigate and clear layout. I would just add that piece where if we click on a sub topic from table of contents, it takes us to that page automatically instead of scrolling around.

Yes, very clear and logical flow.

Interface rating: 5

Its easy to navigate. I would add a little more images as it gets monotonous reading it. WIth a topic like health, lot more colors and contrasts and images can be added.

I did not find one.

Cultural Relevance rating: 5

Not offensive. But I would actually add more of culture and diversity when it comes to health. Why are some cultures "Healthy"? or "why is disparity between genders with access to healthcare across the globe/developing nations"?

It is an interesting book. I liked reading it and refreshing some of the topics. I would just add some case studies and activities to make it more interactive instead of passive reading. May be we can have a supplemental lab with it? Its not a perfect book as it covers upper and lower division topics. But definitely, some components can be used as they are well written.

Reviewed by Sara Pappa, Assistant Professor, Marymount University on 2/24/21

The textbook is a comprehensive compilation of personal (individual) health topics, which are clearly defined and described. It would be appropriate for a Personal Health or Introduction to Health/Health Behavior course. It has a table of... read more

The textbook is a comprehensive compilation of personal (individual) health topics, which are clearly defined and described. It would be appropriate for a Personal Health or Introduction to Health/Health Behavior course. It has a table of contents, but not an index or glossary. It does not highlight key terms. There is a reference list at the end of each chapter--this could be expanded to include helpful links. Chapters do not have introductions or summaries.

The content is accurate and relatively unbiased. It includes current public health topics such as the leading causes of death, social determinants of health and health disparities. I might suggest changing the name of Chapter 12 to Chronic Diseases.

Each chapter is made up of many sections, or short descriptions of the topics. This helps with the organization of the content. There are not a lot of case studies, examples, graphics or anecdotal information to enhance the learning process. The material is somewhat dry the way it is presented (not very engaging).

The textbook is written in clear language and at an appropriate reading level for college students.

The chapters are organized in a consistent manner.

The textbook could easily be broken down into smaller units or sections as well as followed in a different order as indicated by a course or instructor. The short sections, as well as the chapter and section/sub-section numbering systems, make it easy to follow.

The textbook is organized in a clear manner, with chapter and section titles that make it easy to follow.

The textbook is easy to read and navigate.

The textbook is well written with few grammatical errors.

The textbook does include some references to culturally competent content. It would be improved with the addition of specific examples, including data and research, about cultural differences and how these affect health.

Reviewed by Sarah Maness, Assistant Professor, Public Health, College of Charleston on 1/27/21

Covers a wide variety of health promotion topics, primarily at the individual level. Lacks a section on social relationships and health. Only covers romantic relationships and in ways that are culturally dated (section on Married and Non-Marrieds). read more

Comprehensiveness rating: 3 see less

Covers a wide variety of health promotion topics, primarily at the individual level. Lacks a section on social relationships and health. Only covers romantic relationships and in ways that are culturally dated (section on Married and Non-Marrieds).

Content Accuracy rating: 1

I would not feel comfortable using this text in my class based on issues with accuracy. Section 1.7 about Determinants of Health mentions Healthy People 2020 however does not describe the Healthy People Social Determinants of Health Framework when talking about Social Determinants of Health and includes different factors. Citations are very dated, 2008 or earlier when this edition came out in 2018. Healthy People 2030 is now out so next version should update to that as well. Bias encountered in the chapter about relationships and communication. Only covers romantic relationships and is written with from a heteronomative perspective that also centers marriage and is stigmatizing to those who are not married. ("Marriage is very popular..because it does offer many rewards that unmarried people don't enjoy." "There are known benefits to being married an in a long-term relationship rather than being single, divorced or cohabiting). Also refers to attempts to legalize same sex marriage in this chapter, which has been legal for years now. References are not formatted in AMA or APA style which is standard for the field. Wikipedia is used as a reference in Chapter 2. Chapter 6 discusses "options" for unplanned pregnancy (including taking care of yourself, talking to a counselor, quitting smoking) and does not mention abortion as an option. HPV vaccination recommendations need to be updated.

Relevance/Longevity rating: 2

All topics are relevant but the supporting statistics are outdated by more than a decade in many places. Years are not included in many statistics, nor in the citation at the end of the chapter.

Clarity rating: 3

The sections read as rather disjointed. Chapters could be more aligned and have improved flow for the reader to understand how concepts are related. For example, going right into theoretical models of behavior change in Chapter 1 is early and advanced for an introductory text.

Consistency rating: 2

In the Introduction it states the book is about health, health education, and health promotion. Since health promotion is broader than health education, and fits the topics of the book, it is not clear why this is not the title instead. This book could be useful for an introduction to health promotion class but instructors may overlook it because of the name. Some chapters contain no in text citations despite stating facts, while others contain many. Reference lists and in text citations are formatted differently in different chapters.

Almost too modular, not clear how some sections relate and there is not a lot of detail in many subsections.

Organization/Structure/Flow rating: 3

The sections within each chapter often seem disjointed and do not include enough detail in each section.

Interface rating: 3

In many chapters, only weblinks are provided as citations. If the link is broken, there is no title, author, journal or year for reference. Figures included without citations (ex: Social Readjustment Rating Scale).

Grammatical Errors rating: 3

Did not notice overt grammatical errors.

Includes examples and text of people of multiple races and ethnicities. Is not inclusive based on sexual orientation and in terms of the way it discusses marriage and relationships.

The cover does not appropriately capture what the book includes. It could be more representative of health than just a sports field/physical activity. Health is multi-dimensional and includes in addition to physical - mental, emotional, spiritual, occupational aspects, which the book acknowledges in the text. Hair and clothing style of people on cover also look outdated.

Reviewed by Corrie Whitmore, Assistant Professor, University of Alaska Anchorage on 11/11/20, updated 1/10/21

This book was developed for a Health 100 class. It covers a wide variety of personally relevant health topics, with segments defining health, discussing "your bodies response to stress," describing threats to environmental health, and offering a... read more

This book was developed for a Health 100 class. It covers a wide variety of personally relevant health topics, with segments defining health, discussing "your bodies response to stress," describing threats to environmental health, and offering a guide to "understanding your health care choices," which includes both nationally relevant and California-specific information. The index is detailed and specific. There is no glossary.

This textbook would be appropriate for a lower division personal health course. Some components would be useful in an introductory public health course, such as the "Introduction to Health," "Infectious Diseases and Sexually Transmitted Infections," and "Health Care Choices" secgments.

The text is not appropriate for a "Fundamentals of Health Education" or "Health Promotion" course aimed at future Health Educators.

Book provides accurate information with clear references to unbiased sources (such as the CDC for rates of diseases).

Content is releveant and timely.

The book is appropriately accessible for lower division students, with clear definitions of relevant vocabulary.

Good internal consistency.

The segmentation of the book into 14 topical sections, each with subsections, makes it easy to assign appropriate chunks of reading and/or draw pieces from this text for use in other courses, such as an introductory public health course.

Well-organized.

Easy to navigate.

Good discussion of health disparities, acknowledges cultural components in health. Is not insensitive or offensive.

Reviewed by Audrey McCrary-Quarles, Associate Professor, South Carolina State University on 8/17/20

The Health Education book covered all the components usually found in other basic health books. It can be utilized as an Open Textbook for students taking the introduction to health or the basic health course, such as HED 151 - Personal and... read more

The Health Education book covered all the components usually found in other basic health books. It can be utilized as an Open Textbook for students taking the introduction to health or the basic health course, such as HED 151 - Personal and Community Health.

The author could use a picture that exhibits diversity on the cover.

Some of the data is just a little outdated but can be updated very easily with an article or current chart.

Clarity is okay.

Consistency is good!

Should be an easy read for students.

Organization and flow are great!

Text can use some more pictures and charts, especially in Chapter 1.

Did not notice any grammar errors in scanning over the book.

The cover should be a picture that depicts diversity as well as showing more diversity throughout the book.

Overall, the book serves its purpose. It is good!

Reviewed by Vanessa Newman, Adjunct Faculty, Rogue Community College on 7/22/20

The textbook successfully covers a wide array of health education topics. The chapters on "Relationships & Love" and "Health Care Choices" were excellent additions to what you find in many health books. Overall, I would have liked to have seen... read more

The textbook successfully covers a wide array of health education topics. The chapters on "Relationships & Love" and "Health Care Choices" were excellent additions to what you find in many health books. Overall, I would have liked to have seen more case studies, illustrations, examples, and quick quizzes to reinforce the content presented and to reach students with different learning styles. Many of the sub-topics could be even more robust with the addition of information on auto-immune disorders for example or a section on health education professionals like personal trainers and health coaches or information on what to do if you suspect a food-borne illness and how to access help.

The contributors have done a great job of presenting accurate information but it is now outdated in many sections and chapters which is what happens in textbooks generally. The language and presentation of material appears unbiased. The addition of more graphics and examples that cross demographics, cultures, and races would be a welcome addition. I found no factual errors but did question the notion that gluten-free diets can assist with anemia and wondered if research about the resilience gene in children might be referenced.

The research presented is all 2015 or before with an emphasis on 2008 information. Sections about marijuana and cannabis, infertility, social disorder, and smoking need refreshing. It would be helpful to have information about genetic testing (23 and me and Live Wello) added, functional fitness addressed, and infectious disease content brought up to date. So much has happened affecting people's health has transpired since 2015 that it is time for updating. Also, more information in sections like how baby birth weight can predict chronic disease development and mindfulness as a practice for improved quality of life.

Content is presented in clear, concise and appropriate language. Every once in a while there is a sentence structure issue or a word ordering that is clarified by a re-read. There is not an emphasis on jargon or overuse of idioms in my opinion. All terminology was defined or given reference as to where to locate additional information. Again the use of diagrams, illustrations, more examples would also improve clarity and accessibility for some. I did not recall seeing information on how many calories are in a gram of protein, carbohydrate and fat presented. And relevance affects clarity. For example, including language about portal of entry and exit in the infectious disease section.

Having a quick quiz at the end of every chapter would have added consistency. Also standardized formatting for charts and graphics would improve the textbook overall as well. The chapters, sections and headings all appear consistently presented. There was nothing presented that was jarring or appeared out of context. References looked similar and were all summarized at the end of each chapter.

Modularity was this textbook's strength. Large chunks of information were broken down into manageable sections and sub-sections and the white space was appreciated. Because of this, the information did not seem overwhelming or "too much too fast." Students can take breaks and not lose track of where they were or forget critical information. Again, more examples, quizzes or case studies could also improve modularity and add an interest factor. The table of contents was thorough.

Time was taken to decide which chapters and topics should be presented in which order. The flow was organic, natural and later sections built on previous information. The structure of the textbook made sense and usually my questions about a topic or subject were answered within the same page. I had no complaints about organization and could find sections easily based on the table of contents.

No interface issues for me, but I was reading on a personal computer and perhaps on a tablet or phone there would be.

The paragraph spacing was not what I would have chosen. There were some inconsistencies. There are contractions like isn't which I prefer not to see in textbooks because it is too casual a style for me. Many instances of punctuation coming after quotations, but this may have been a style choice. The font seemed appropriate but more bolding or color would keep the reader's attention. There are spelling errors on the food chart on p. 236. Some issues with singular vs. plural. For example on P. 64 "nightmares" needs to be plural. A few places where punctuation is missing.

The text is not culturally insensitive, but without additional examples, graphics, and diverse charts it becomes a bit bland. The reference to a handgun on p. 56 was uncomfortable for me. Under weight management, there could be more information presented on how different cultures appreciate varying body types and have different food rituals and discussion on how not to "fat shame" others. Some examples of cultural influences could be presented in the infectious disease section like how practices for burying the dead can lead to disease and how food preparation affects disease management.

I thought it was comprehensive and well organized. If it were not for relevance issues, I would choose to use this book in our general health class.

Reviewed by Robert West, EMS Program Director, North Shore Community College on 6/7/20

Health education is an enormous subject area but this text does an excellent job covering the most important topics. The comprehensive nature of it topic coverage does come at the cost of not being comprehensive within any single topic- this book... read more

Health education is an enormous subject area but this text does an excellent job covering the most important topics. The comprehensive nature of it topic coverage does come at the cost of not being comprehensive within any single topic- this book is an overview that provides an excellent framework for further study and exploration.

Topics within Health Education are inherently subject to bias- religious, cultural and generational perspectives often influence the scientific and open-minded exploration of issues in topics like sexuality, nutrition, and relationships. This book clearly strives to support perspectives with research and did not shy away from topics like abortion and gender roles.

The greatest weakness of this text is that it often feels outdated. Health information is dynamic and no text can always be current, but there are sections that are clearly too old to be considered useful unto themselves. Examples: The narcotic abuse epidemic is absent. This is a major issue in substance abuse and the text primarily looks at heroin abuse without examining the larger issue of prescription narcotic gateways to abuse, or even other narcotics of abuse. The use of PrEP for reducing HIV transmission has been available since 2012 but is not mentioned. The section covering sexual orientation and gender identity cites the 1993 Janus Report for its source of statistics. There is no publication date listed in the text- the latest citation that I noticed was 2015 but most come well before 2010, making the text a decade old in a field that changes rapidly.

The text is well-written and easy to comprehend.

Consistency rating: 3

The Acknowledgements page at the front of the book states that it was "compiled by..." and this speaks to the way the text appears. There is no consistency is the writing of the book. Some chapters are broken down into Sections, brief (often only a paragraph long) collections of sentences that seem to address a behavioral objective that we do not see. Other chapters are written like a standard text and then some appear in a question-and-answer format. None of these are inherently problematic, but the changing style may trouble some readers.

Chapters and chapter sections are clearly delineated.

Chapters are well organized- there is no logical order into which one must teach the various issues of health. The readings of this text could easily be sequenced as desired by the instructor.

The interface is clean and simple. There are few images/illustrations- they would be a welcome addition.

The text is well-written and contains no grammatical/spelling errors that I noticed.

Overall the text seems fair and cites studies to provide evidence of its claims, though some sections simply feel less than open-minded. In the discussion of marriage vs. cohabitation (does anyone use that word anymore?), the text lists advantages of being married that include less likely to commit crimes and less addiction. Statistically, perhaps, but is there a causal relationship? A single paragraph addressing "spiritual health" states: The spiritual dimension plays a great role in motivating people’s achievement in all aspects of life. Some people, yes, but it's not a global truth. Race is never addressed as a topic within the text, though it is commonly listed when a risk factor of disease, health care disparity, etc.

If updated, this would be a superb book. As it stands, it provides an excellent framework for a college course in General Health from which the instructor, or students, could be directed to contemporary writings on these issues. An instructor could readily assign chapter readings and then short research projects that would that could be shared with the class as a whole to assure present day relevance.

Reviewed by Kathy Garganta, Adjunct Professor, Bristol Community College on 5/26/20

The textbook covers a variety of topics in a choppy sequence jumping from three chapters on sexuality and sexual health to substance abuse then onto nutrition. The book was limited in depth and many areas needed additional explanation. There are... read more

The textbook covers a variety of topics in a choppy sequence jumping from three chapters on sexuality and sexual health to substance abuse then onto nutrition. The book was limited in depth and many areas needed additional explanation. There are many lists that did not have the background explanations to support the lists. Several areas were lacking details and were not at college level.

Content Accuracy rating: 3

The text was generally accurate, but lacked backup documentations. Several phrases or statements appeared subjective without the supportive documentation that could lead to misinterpretation. For example, page 107, Section 6.6, Sexual Frequency is covered in one paragraph. In it a statement, “although satisfaction is lower in women,” is delivered with no backup explanation. On page 149, section 7.11, Sexually Transmitted Infections begins with a list of twenty different infections without clarity of an opening explanation.

Relevance/Longevity rating: 5

The textbook was written in 2018 and is still current today. Because of the changing nature of health, it will need updating.

The text was basic and often used lists without additional explanations. Many sections were too brief leaving the reader confused. Page 210 contained an example of a diet list. The list for 4 healthy diet approaches was followed by confusing numbering.

The structural set up of headings and subheadings were consistent, but occasionally spacing was off.

The use of headings and subheadings were helpful. The table of contents clear and easy to follow. Often the sub headings were very short and needed additional information to validate their statements. As an OER text, sections could be assigned as resources to courses outside of health.

The topics were arranged with an unusual flow. Having three chapters on sexuality before nutrition changed the flow and weight of importance.

The text is free of significant interface issues. The chapter headings in the table of contents allows for easy navigation. The use of charts, color displays, photos would have assisted in explaining the topics. The chapter’s would benefit with a more engaging approach. Introspective questions or activities would help to relate material to students lives.

The text contains no significant grammatical errors. However, spacing and formatting needed consistency. For example, on page 86, five definitions all begin with the same exact phrase, throwing off the reader’s flow. On pages 285-86 the formatting/spacing is off.

The text should make greater use of photos/drawings that are reflective of a variety of gender, races, and backgrounds.

Grateful to the author for contributing to OER resources.

Reviewed by Sonia Tinsley, Assistant Professor/Division Chair, Allied Health, Louisiana College on 4/28/20

Covers a variety of health topics that are typical to a personal and community health course. However, the information is very brief. read more

Covers a variety of health topics that are typical to a personal and community health course. However, the information is very brief.

Content is accurate. However, some chapters tend to be limited with reference information.

Some chapters include a limited number of statistics and references but could be updated.

Information is basic and easy to follow.

Terminology used is consistent throughout the text.

The information can be divided into modules to use throughout the course.

Topics are organized and easy to follow.

There were not any features in the text that seemed to be distracting or confusing.

There were no glaring grammatical errors.

The text was very basic and seemed to be written for a variety of races, ethnicities, and backgrounds.

Would have been helpful to have more self-appraisals for readers to complete and make information personable.

Reviewed by Jeannie Mayjor, Part-time faculty in the Health and Human Performance Dept., Linn-Benton Community College on 1/15/20

I think this book does a great job of making the material presented easy to understand. Many similar textbooks are more advanced due to more challenging word/term choices, but this book would work well for anyone taking an intro level class in... read more

I think this book does a great job of making the material presented easy to understand. Many similar textbooks are more advanced due to more challenging word/term choices, but this book would work well for anyone taking an intro level class in health.

The book doesn't cover any of the topics in an in-depth manner. Since it's an intro-level textbook, there aren't many complicated ideas to present where accuracy could be a problem. I think some areas, like nutrition, are missing more up to date info, but that could be remedied by incorporating more recent articles and info from various health journals.

Since this text provides an easy to understand overview of health, it would be easy to update. There are no cutting edge or controversial views expressed in the book, so it does have longevity, but again, there will be a need to present more up to date info to supplement the general understanding that the students will have after reading this text. I like the section on sexual health/identity/orientation in the Sexuality chapter. One more chapter that I appreciate is the chapter on psychology: the most common mental health disorders that college-aged students encounter is important and the section on resilience in both the psychology chapter and the stress management chapter are greatly needed.

The book is very clear and understandable. After having taught a health class every term for the past twenty years, I think the way this book is written would appeal to most students.

I did not catch any inconsistencies in this text. Topics discussed in early chapters might come up in later chapters at times, but the info presented the second time around is consistent with earlier explanations of ideas and terms.

Larger type on chapter headings would help improve the ability to divide the book into smaller reading sections, it's easy to miss the start of a new chapter when scrolling through the text. Once you are in a chapter, the subheadings are helpful in dividing the chapter into smaller reading sections. I wish the chapter on cardiovascular diseases (coronary heart disease and stroke) was limited to those two diseases, without including a section on cancer. I think the topic of cancer deserves its own chapter.

The text is well organized and chapters flow into each other in logical ways. There are enough chapters to spread this out over a ten or 15 week term/semester. The chapters are short enough that you could easily assign one and a half chapters or two chapters for one week's worth of classes.

I would have liked to see more photos, although there are plenty of graphs, and I enjoyed the interactive quiz called The Big 5 Personality Test, I would have liked to see more. Some of the links listed in resources are no longer working, and one link in the Fitness chapter is not working, (Adding Physical Activity to Your Life) and I had been looking forward to exploring the topic in more depth. The MyPlate.gov website has been significantly changed, around the time that this book was published, so some of the links to that site no longer work.

I usually notice grammatical and spelling errors, as well as missing words, but I did not encounter anything obviously wrong in my reading.

The text could use more cultural references. I would have liked to see more acknowledgement of cultural differences and references to the health of people from other cultures, especially as it relates to changes they may encounter once a person from another country moves here.

Great overview of the various topics covered in a 100 or 200 level college health class. I will use sections of this book to help simplify some of the topics that my students find challenging, for instance, the fitness and heart health chapters/sections. Due to the inclusion of many of the mental health disorders that our students encounter, I will fit in some of the sections in the psychology chapter. I look forward to implementing some of the material in this text into my health classes.

Reviewed by Jessica Coughlin, Assistant Professor , Eastern Oregon University on 1/6/20

This textbook includes very similar topics to most of the college level health education books that are available today. While the book includes many of the main points related to each topic, it does not go into too much depth. However, this... read more

This textbook includes very similar topics to most of the college level health education books that are available today. While the book includes many of the main points related to each topic, it does not go into too much depth. However, this limitation can be solved by supplementing the book with scholarly articles. Based on the number of chapters and the amount of information, I think this book would be beneficial for a 10 week or 16 week term.

The book cites quality sources, however it would be helpful to include in-text citations since the references are only at the end of the chapters and it is difficult to know where the information is coming from. This is especially important for time sensitive information such as statistics. Also, some information seems to be directly from the sources, but it is not cited.

The information is mostly up to date, however as stated before, including in-text citations would help readers have a better idea of the relevance of the material. Also, there are limited references for each chapter.

The material is delivered in a clear and concise way. Adequate context is provided for terms and concepts.

The format of the text-book is consistent as is the type of delivery for the information.

The text includes a good amount of headings and sub-headings, which makes it easy to break the information down into smaller reading sections.

The book has a good flow to it. Each section within the chapters is well-organized and provides a logical progression.

The book is free of any significant interface issues, however there are some small issues such as spacing and formatting errors. Additionally, some small changes such as larger title pages for each chapter would be helpful as well as more graphics and pictures.

I did not notice a significant number of grammatical errors.

The text is not culturally insensitive or offensive. Like most textbooks, it could provide more examples that navigate the relationship between health and different backgrounds.

I would use this textbook, along with other supplemental materials for my course. It reviews the main topics I currently cover in my course and has less limitations than many overly-priced books.

Reviewed by Kathleen Smyth, Professor of Kinesiology and Health, College of Marin on 4/17/19

This textbook covers the myriad of required topics for an Introductory Health Course. The table of contents includes all of the topics I cover in my classes. No textbook is perfect and this book is no different but one should not rely on textbooks... read more

This textbook covers the myriad of required topics for an Introductory Health Course. The table of contents includes all of the topics I cover in my classes. No textbook is perfect and this book is no different but one should not rely on textbooks only anyway. This free textbook is an excellent launching point for any contemporary health education course.

One of the greatest challenges in teaching health is to be unbiased given so many factors affect our health like politics, economics, zip code etc. The textbook does a fine job of explaining the role of government. For example: generic drugs and the abortion debate. Any areas in question can be used by the instructor to create a discussion with the students for better/different alternatives or ideas.

Health is very dynamic so the textbook will need to be updated on a regular basis.

This is an easy to read text. The majority of college students will have no issues with the terminology.

For a textbook that is not professionally published I found the terminology and framework sufficient for my needs. Anything missing can easily be added by the instructor and used as a discussion or research assignment for the students.

Maybe the best feature of the text is the modularity. Each section of the table of contents is hyperlinked so one could easily pick and choose the topics assigned to the students.

The organization follows the same logical fashion as all of the top rated professionally published Health Education textbooks.

There are a couple formatting issues but nothing that affects clarity in my opinion. I think because this is free I have lower expectations vs a professionally published textbook and I am ok with this.

I did not notice any obvious grammatical errors.

The text is not culturally insensitive or offensive but it could include in-depth analysis of health status in relation to one's race, culture and zip code. As I mentioned previously this is a topic that can easily be supplemented by the professor.

This free textbook meets all the requirements for an introductory health course. It leaves room for me to do my job to engage my students in more detail by discussing controversial topics while giving them the opportunity to be critical thinkers. I appreciate all of your efforts on this project.

Reviewed by Amanda Blaisdell, Assistant Professor, Longwood University on 4/11/19

It gives a lot of information, but it isn't very "in-depth." Admittedly, it would be a challenge to be very in-depth with one book that covers so many topics. This book certainly lacks sufficient images/pictures. The amount of information varies... read more

It gives a lot of information, but it isn't very "in-depth." Admittedly, it would be a challenge to be very in-depth with one book that covers so many topics. This book certainly lacks sufficient images/pictures. The amount of information varies by topic. For some reason, some topics (that don't seem as important in relation to other priority issues) have much more text and information, while other topics lack in comprehensive quality to a large extent. Types of intimate partner violence is incredibly insufficient. There are LOTS of ways that people are abusive, those 5 bullets are not enough. There are lots of incomplete sections. It seems like most sub-topics are hand-selected.

There are biases in the information. For example, mental health is described with an emphasis on college-aged students. Why? Mental health issues affect everyone. This makes it seem like a college student problem. Another example, on page. 57 a strategy to cope with stress is to "give in once in a while." What are we promoting here? I have taught health education and stress management for years. There is a better way to phrase the point they are getting to.

It seems like it is up-to-date as of right now, but health facts are only good for five years.

Sometimes more jargon is necessary. Too much relying on cultural metaphor.

Not all facts have footnotes so that the reader can find the source of the information. Why do some have a reference footnote but other facts do not? How can we dig deeper and fact-check? The reference sections are hyperlinks, which come and go. Why are the references lacking any actual APA, MLA, or other format? APA would be appropriate. Students emulate what they find in textbooks. Some seem to be in some formal form, but others are not and the formatting is not correct.

Yes, very much so.

Some topics fit in multiple categories, so there should be some in-document link to information.

Some sections have a space between paragraphs... some do not.. it is not consistent or visually appealing (Example, p. 23). Figure 1 on page 51 seems to have highlighting and blurriness on the image. Look on p. 122, what is that symbol before the "Copper IUD"? WHy does it say it twice? Is there a heading that wasn't bold? What is going on?

I don't know if you call this "grammar" per-se, but formatting is not consistent. For example, on p. 55 there is no consistency in capitalization of first words in bullet points. That just seems sloppy and unprofessional.

Don't refer to sexual arousal as being "turned on," as that is a cultural metaphor. Some language needs to be technical because this book is supposed to provide information. There is lots of evidence of attempts at cultural competence, but it doesn't provide enough of that. There are lots of lifestyles that are OK even if they don't fit our Western model.

To be honest, it seems like portions of this book are plagiarized. Is this a rough draft?

Table of Contents

• Chapter 1: Introduction to Health
• Chapter 2: Psychological Health
• Chapter 3: Stress Management
• Chapter 4: Relationships and Communication
• Chapter 5: Gender and Sexuality
• Chapter 6: Sexual Health
• Chapter 7: Infectious diseases and Sexually Transmitted Infections (STI's)
• Chapter 8: Substance Use and Abuse
• Chapter 9: Basic Nutrition and Healthy Eating
• Chapter 10: Weight Management
• Chapter 11: Physical Fitness
• Chapter 12: Cardiovascular Disease, Diabetes, and Cancer
• Chapter 13: Environmental Health
• Chapter 14: Health Care Choices

Ancillary Material

About the book.

Readers will learn about the nature of health, health education, health promotion and related concepts. This will help to understand the social, psychological and physical components of health.

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• J Educ Health Promot

Health education and global health: Practices, applications, and future research

Daliya s. rizvi.

Sindh Institute of Urology and Transplantation in Karachi, Pakistan

Health education is a crucial consideration in the healthcare system and has the potential to improve global health. Recently, researchers have expressed interest in streamlining health education, utilizing digital tools and flexible curriculums to make it more accessible, and expanding beyond disease and substance abuse prevention. They have also expressed interest in promoting global health through health and safety promotion programs. Amidst the COVID-19 pandemic, climate change, the refugee crisis, and overpopulation, healthcare crises are erupting all over the world. A lack of health education has and will continue to have a profound impact on community healthcare indicators, particularly in low-income nations. Current priorities within the health education sector include digitization, equity, and infectious disease prevention. Studies and data from university journals and other academic databases were analyzed in a literature review. Health education programs have a significant positive impact on attitudes and behaviors regarding global health. Improving upon these programs by digitizing them and expanding upon the scope of health education will help ensure that such interventions and programs make a significant difference.

Introduction

Health education is a social science that draws from a multitude of fields, often taking a biopsychosocial approach towards promoting health and preventing disease. It can encompass instruction in hygiene, reproductive health, nutrition, and more, and help address global healthcare crises by giving community members the tools necessary to engage in preventative care measures.

The majority of health education programs are school or organization based and are taught in standardized curriculums with the common goals of preventing substance abuse, the spread of disease, and premature pregnancy. However, recently, there has been a shift in health education towards a more creative and digital approach, and towards an expansion to mental health, preventative care, and more.

This paper discusses current health education program types and studies, along with the future of health education, up-and-coming methods for health promotion, and suggestions for future research within the field.

Materials and Methods

Studies and data from PubMed and Medline, as well as university journals and other academic databases, were analyzed in a literature review encompassing current innovations in health education. The criteria for the studies used were as follows: studies had to (1) be published in English; (2) focus on implementing health education programs and interventions or designing them; (3) be published in or after 1990 to ensure relevance; and (4) be relevant to emerging research in the field of health education. Findings were synthesized into suggestions for future studies in particularly pressing areas.

Past progress and the current situation

The positive impact of health education on physical and mental health is measurable. Meheba Refugee Settlement in Zambia was established in 1971 and hosts tens of thousands of refugees. In the early 2000s, the United Nations High Commissioner for Refugees (UNHCR) implemented a health education initiative in the camp with a focus on preventing the spread of HIV. The UNHCR volunteers engaged with the local community, provided refugees with resources, and taught them how to take advantage of what was available to them to prevent the spread of HIV. Participants were also encouraged to educate others about the dangers of HIV and help teach those around them about potential prevention strategies. These efforts reduced levels of HIV infection; now, the camp has far lower HIV infection rates than the surrounding areas of Zambia, proving the effectiveness of the program[ 1 ] . Similar results were observed in schoolchildren in Thailand who engaged in a health education program to prevent the instance of head lice[ 2 ] . Six schools were selected for participation in the study, and children (who were all females) were divided into control groups and intervention groups [ Figure 1 ]. Baseline data on the presence of head lice was collected. After two months, the intervention group had significantly higher scores on a KAP (knowledge, attitudes, and practice) test, and the percentage of those with pediculosis (caused by a lice infestation) decreased from 59% to 44%. The control group, however, experienced no significant changes.

Maatai women participate in a health education program created by the Unite the World with Africa Foundation, focused on sanitation, family planning, nutrition, HIV/AIDS, and more[ 3 ]

A recent study conducted by an epidemiologist at the Global Disease Detection and Response Program and supported by the United States Centers for Disease Control and Prevention (CDC) focused on studying the effects of a hand hygiene–based health education program on influenza and influenza-related disease rates among schoolchildren in Cairo, Egypt.[ 4 ] The control group of students did not receive a health education program. The intervention group received a program that consisted of hand-washing requirements and educational activities related to hygiene. The program was taught in a creative and engaging manner to hold the attention of students and educate them about the importance of preventative hand washing and general cleanliness to combat germs. At the end of the study, school absences caused by influenza were reduced by 50% in the intervention group when compared with the control group,[ 4 ] illustrating the effectiveness of a well-implemented health education program on community health.

Health education programs are beneficial for more than preventing the spread of disease. They can be used to maintain health, improve cognitive functioning, and increase healthy behaviors. In Iran, a study was conducted to determine the effects of a health education program on the overall health and glycemic control of patients with type 2 diabetes. The study found that all clinical measures and lifestyle factors that were evaluated improved in the health education group when compared with the control group.[ 5 ] These findings were crucial because they established that rehospitalizations and complications arising from chronic conditions were not necessarily hindrances for patients. Similar programs could reduce strain on the healthcare system and are discussed in detail below. Another study evaluated the effects of a health education program in improving the cognitive capabilities of elderly participants in a University of the Third Age (U3A) program. The study found that health education program participants had significantly improved their cognitive examination and memory domain scores when compared with control group participants.[ 6 ] These results suggest that health education can expand beyond its traditional uses. The use of cognitive health education to improve the cognitive functioning of older adults could be used to combat the adverse effects aging has on memory, fluid intelligence, learning, and problem-solving, which is extremely promising. Cognitive health education programs are an important consideration for future health education research.

The International Journal of Dental Hygiene published a 2017 study that described the efficacy of oral health education programs among varying age groups. After conducting a systematic review and meta-analysis of 11 studies on the subject, it was apparent that oral health education programs and interventions led to increases in dental visits and improvements in brushing and flossing. These effects were often observed in children but were also observed in adults.[ 7 ] It is clear that health education programs lead to an increase in knowledge and behavior alike, changing the perceptions and practices of patients. They can be used to increase healthy behaviors in even skeptical or reserved patients.

Health education programs can also be utilized to prevent chronic illnesses, improve overall population health, and reduce the burden conditions like obesity and osteoporosis can place on underfunded healthcare systems. A 2017 study researched the impact of a targeted health education program on the lifestyle habits of middle-aged women at risk of osteoporosis.[ 8 ] The study concluded that the women in the intervention group who received a health education program had increased levels of physical activity, an increased daily calcium intake, and increased levels of general knowledge of osteoporosis. Although the progress of the study participants was not tracked in the long term, it is plausible that these changes in lifestyle habits could have delayed or even prevented the onset of osteoporosis in some of these women. Engaging citizens with predispositions to such diseases using programs for diabetes, obesity, and even cancers could be extremely beneficial in both the short and long term.

A 2019 review analyzed studies focused on health education programs designed to promote maternal and child health.[ 9 ] The study focused on 23 articles on various educational methodologies or program designs and technologies. Educational programs focused on various topics, including breastfeeding and pediatric dentistry. The programs yielded an abundance of positive results, including increased confidence, increased birth weight and gestational age at birth, increased prenatal visits to ensure fetus health, and higher rates of safe behaviors during pregnancy (avoiding alcohol, nicotine, drugs, etc.). The review concluded that continued health education programs led to improved outcomes for both the mother and child.[ 9 ]

Poor menstrual hygiene, caused by period poverty, can lead to a variety of negative effects on one's physical health, including urinary tract infection (UTIs) and issues with the reproductive system (UNICEF). In areas where girls are already marginalized in schools, and where many young women skip classes when they menstruate, infections caused by unhygienic practices can take a significant toll on both a young woman's education and her daily life. Many poverty-stricken areas do not have resources such as transportation, pharmacies, and healthcare infrastructure, and home remedies can often be more harmful than helpful. Thus, eradicating dangerous practices like poor menstrual hygiene is imperative. In 2007, a study measured the impact of a community-based health education program on the menstrual hygiene practices of adolescent girls in India. The researchers found that the health education program increased awareness of menstruation and led to a 28% decrease in the unhygienic reuse of cloth and menstrual products,[ 10 ] which in turn improved the reproductive health of adolescent girls in 23 villages.

Health education has been associated with a reduction in risky behaviors and an increase in academic achievement.[ 11 ] Additionally, it can help change the attitudes citizens have towards infectious diseases. Between 2012 and 2013, a study conducted in Gansu, China, recorded differences in knowledge of the spread of infectious diseases between two groups of high school students.[ 12 ] Although education level, income, and gender also affected the results, education had the most significant impact. Those in the intervention group exhibited more cautious behaviors after a health education program.

Among older students, health education programs can improve sexual health and reduce instances of violence and the abuse of certain substances. Often, these programs can involve more than classroom instruction. Programs with multiple components, including parental and community involvement and changes in school policy,[ 13 ] can have a positive effect on sexual safety, nicotine abuse, and bullying in school. Evidence suggests that when compared to other measures such as anti-smoking policies and a targeted approach towards 'at-risk’ students, school-based health interventions and education programs have a greater positive impact on student health.[ 13 ] Similarly, a Japanese study with the goal of measuring the effect of a comprehensive alcohol-focused health education program on alcohol abuse among junior college students found that the program reduced instances of alcohol abuse among the primarily female study group, despite limitations to the research.[ 14 ] Combating risky behaviors through education rather than the systematic targeting of students who are perceived to be at risk is a more beneficial approach.

At times, health education programs can encompass education in nutrition, particularly in areas where it is difficult to control one's meals and readily obtain foods that provide the variety and nutrition that characterizes a healthy diet. Exploring the impact of health education on food sourcing behaviors is a key step when determining how to best combat the obesity epidemic through the people suffering from it. A 2015 study measured the effects of a nutritional health education program on the knowledge and behavior of primary school students regarding nutrition in two low-income counties in China.[ 15 ] Students in the intervention group had increased behavior and knowledge scores, suggesting that the health education program had an impact on the way they approached food and food safety. Attitude scores, however, stayed relatively consistent.[ 15 ] In Spain, researchers found that physical activity and nutrition education programs yielded positive results and increased acquisition of healthy behaviors.[ 16 ]

Evidence has suggested that health education can become a vital aspect of therapy and recovery for patients with physical and mental conditions. A review examining the effects of health education programs on treatment outcomes in patients with heart failure analyzed several studies on the subject.[ 17 ] The studies that were analyzed measured a variety of variables, including the impact of health education on the quality of life of the patient, the patient's knowledge of their disease, the patient's level of self-care, and the patient's adherence to any pharmaceutical prescriptions recommended by their physician.[ 17 ] Data suggests that health education increased patient knowledge about heart failure, and had a significant impact on the patient's adherence to medications.[ 17 ] This suggests that health education programs could be used further to influence lifestyle changes in patients suffering from chronic illnesses. These programs would reduce rehospitalizations and patient health, thereby preserving healthcare resources.

The world is also currently facing a mental health crisis, with levels of anxiety and depression skyrocketing among groups of all ages, and particularly among young people.[ 18 ] Mental health awareness and education programs have the potential to reduce the stigma around mental illnesses and improve the overall mental health of students. Health education programs can also reduce risk factors of mental illnesses. For example, they have been utilized to combat drug addiction[ 19 ] and teen pregnancy: factors with a significant impact on the mental health of young adults. Although many of these programs are in their early stages, they could have a positive impact on the mental and physical health of young people by reducing stigma and rates of anxiety and depression.

Modern students live in a technological era in which cell phones, tablets, computers, and video games are core elements of daily life.[ 20 ] Thus, it is necessary to digitize programs that focus on student mental health and wellbeing. Digital programs and educational games could increase student health by presenting material in a more engaging, relatable, and convenient way. A 2019 review evaluated the impact of digital mental health interventions (internet resources and apps focused on educating users about mental health maintenance) on the psychological wellbeing of college students.[ 21 ] The review analyzed approximately 89 studies and recorded a common trend of improvement in symptoms of anxiety and depression, as well as improvement in the overall mental health among students. However, researchers noted that more rigorous studies were needed to fully measure the impact of these programs.[ 21 ] Making digital health education programs free and widely available is necessary. Ensuring that these programs meet established standards and are scientifically accurate is a significant challenge that must be met with extensive research.

The shift towards digitized health education has given rise to methods intended to educate students more creatively. Researchers designed a sexual health education game-based program for adolescents. The goal of the program was to combat unhealthy sexual behaviors, educate young people about safety and prevention practices, and encourage young people to discuss sexual health matters.[ 22 ] The game program was anonymous, allowing students to learn topics without fear of social pressures or stigma.[ 22 ] Programs like this emphasize learning through interactive activities and educate students free from the biases and reservations that traditional sex education teachers may have. They can also be utilized in areas where levels of STIs (the most common being HIV and chlamydia) are high to educate adolescents about safe practices.

The path forward: Suggestions for future work in health education and health promotion

Many educational institutions have implemented education and prevention programs for students that are intended to curb the usage of drugs and alcohol. Although similar programs focused on nicotine have been successful, programs that target 'at-risk’ students and focus on drugs have largely been unsuccessful. Genetics play a large role in the susceptibility of many to drug and alcohol abuse. Current health education programs do not account for this fact and are not tailored to each student's needs, background, and learning style. Research exploring the nuances of health education relating to the prevention of substance abuse is necessary.

Health education can play a major role in reducing stigma around conditions such as mental illness and AIDS, thereby reducing reservations among patients who avoid seeking care due to the judgment they could face from their peers. Research on widespread health education campaigns has occurred; however, their efficacy must be further investigated. Navigating cultural and social barriers could serve as significant challenges for such programs; thus, prevention strategies must be researched as well. The implementation of stigma reduction programs would likely improve the standard of care for marginalized patients, thus positively impacting global health.

There are multiple health education models that must also be taken into consideration. Thus far, the rational model is the most promoted of the available models. Focusing on presenting unbiased information, this model is based on the belief that becoming educated on a subject will change a person's behavior. However, this is not always the case. The health belief model emphasizes the fact that people often make irrational decisions when it comes to their healthcare, regardless of the educational resources available to them; many prefer to live in blissful ignorance rather than face the fact that one has a terminal illness. Hypochondria, low self-efficacy, and perceived obstacles can serve as barriers to healthcare. The extended parallel processing model takes a more biased and emotionally charged approach to health education in order to strongly persuade people to take charge of their own health and practice better prevention strategies. These theories are crucial for the development of a health education program that balances science and education, with successful management of the often erratic and unpredictable behavior of patients. Future studies must consider which combination between the available models is the most effective, both in the short and long term.[ 23 ]

Behavioral theories have been helpful to psychologists and sociologists when determining the best methods of education and persuasion for the general public. Social learning theory describes the idea that people are disproportionately impacted by their environments. This is crucial to note; health education programs must vary depending on the area and the cultural background of the people partaking in the program. Different strategies will work in different populations, and future studies must take this into account.[ 24 ]

Currently, citizens with disabilities (physical and intellectual alike) are discriminated against in the workforce. In fact, the unemployment rate for those with disabilities is over two times that of those without disabilities.[ 25 ] Health education programs can be utilized for sensitivity and diversity training in various corporations to emphasize the importance of reducing discrimination against potential employees with disabilities. Establishing mandatory programs focused on educating company employees about common disabilities such as autism and Down's Syndrome, for example, could increase levels of understanding and empathy, and lead to a more inclusive work environment. Studies have repeatedly correlated employment and reemployment with better physical health.[ 26 ] Those who are employed have higher levels of security and better mental health because of the lack of stress caused by financial instability. Thus, employing more citizens with disabilities would likely have a positive impact on global health by increasing the physical and mental well-being of a marginalized population.[ 27 ]

The United States and other nations are suffering from epidemics of obesity, heart disease, cancers, and diabetes. The onset of such diseases can be prevented by a reduction in inflammation and the maintenance of a healthy bodyweight and diet, along with stress management techniques. These lifestyle factors can be instilled into students at a young age, thereby vastly improving global health. Currently, most school-based health education programs are limited to substance abuse prevention and family life education or sex education. Health education programs in mindfulness, nutrition, and effective exercise routines can help improve the overall health of student populations. Current literature has suggested that theory-based interventions could reduce the risk of those who are predisposed to cardiovascular diseases.[ 27 ] Because such programs have not been implemented in most public-school systems, research into the nuances and standardization of this type of curriculum is crucial.

Health education programs must be used to empower patients to make their own decisions about their healthcare. Thus, tailoring programs according to the type of intervention and end goal is necessary, as differing program formats can yield different outcomes.[ 28 ] The same is true for the type of theory used.[ 29 ]

This study conducted a systematic search of PubMed and Medline databases to identify 42 studies that were published after 1990 in English, and that focused on implementing novel health education programs. Priority was given to studies that had digital components, focused on cognitive science, or focused on rehabilitation and recovery rather than disease prevention (although some studies discussed also focused on disease prevention). Many of the studies used were discussed in an in-depth literature review, and findings were synthesized into suggestions for future work to streamline, modernize, and greatly improve health education practices.

This study is novel as it evaluates varying types of health education programs as they relate to health promotion beyond the widely known scope of health education. By discussing the relation of health education to mental health, cognitive functioning, digital healthcare, and supplemental care, this study places an emphasis on future research and discovery and provides valuable insights into a rapidly approaching era of health education rather than simply summarizing what is already known. Additionally, this study provides concrete, implementable suggestions for future research into a variety of aspects in health education.

Despite this, the study also has its limitations. There is a lack of adequate research regarding the potential cognitive benefits of health education programs, as the concept is relatively new. Additionally, relevant research studies may have been omitted from the paper as a result of gaps in literature-searching practices.

Health education programs and advocates can help change the way we approach healthcare by championing preventative care to minimize the risk of chronic illnesses, outpatient care, and infections. They can also help reverse some of the negative effects associated with addiction and aging. Digitizing programs and utilizing flexible curriculums is particularly beneficial. As the world recovers from the COVID-19 pandemic and the current healthcare system is reevaluated, health education programs are a crucial consideration that can have a tremendous positive impact on the lives of citizens around the world.

Ethical approval

Financial support and sponsorship, conflicts of interest.

The author declares no conflict of interest.

DNC Night 2

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Live fact check: Night 2 of the Democratic National Convention

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Live updates: The Obamas and Doug Emhoff are set to speak on Day 2 of the DNC

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• Copy URL https://www.pbs.org/newshour/politics/fact-checking-warnings-from-democrats-about-project-2025-and-donald-trump

Fact-checking warnings from Democrats about Project 2025 and Donald Trump

This fact check originally appeared on PolitiFact .

Project 2025 has a starring role in this week’s Democratic National Convention.

And it was front and center on Night 1.

WATCH: Hauling large copy of Project 2025, Michigan state Sen. McMorrow speaks at 2024 DNC

“This is Project 2025,” Michigan state Sen. Mallory McMorrow, D-Royal Oak, said as she laid a hardbound copy of the 900-page document on the lectern. “Over the next four nights, you are going to hear a lot about what is in this 900-page document. Why? Because this is the Republican blueprint for a second Trump term.”

Vice President Kamala Harris, the Democratic presidential nominee, has warned Americans about “Trump’s Project 2025” agenda — even though former President Donald Trump doesn’t claim the conservative presidential transition document.

“Donald Trump wants to take our country backward,” Harris said July 23 in Milwaukee. “He and his extreme Project 2025 agenda will weaken the middle class. Like, we know we got to take this seriously, and can you believe they put that thing in writing?”

Minnesota Gov. Tim Walz, Harris’ running mate, has joined in on the talking point.

“Don’t believe (Trump) when he’s playing dumb about this Project 2025. He knows exactly what it’ll do,” Walz said Aug. 9 in Glendale, Arizona.

Trump’s campaign has worked to build distance from the project, which the Heritage Foundation, a conservative think tank, led with contributions from dozens of conservative groups.

Much of the plan calls for extensive executive-branch overhauls and draws on both long-standing conservative principles, such as tax cuts, and more recent culture war issues. It lays out recommendations for disbanding the Commerce and Education departments, eliminating certain climate protections and consolidating more power to the president.

Project 2025 offers a sweeping vision for a Republican-led executive branch, and some of its policies mirror Trump’s 2024 agenda, But Harris and her presidential campaign have at times gone too far in describing what the project calls for and how closely the plans overlap with Trump’s campaign.

PolitiFact researched Harris’ warnings about how the plan would affect reproductive rights, federal entitlement programs and education, just as we did for President Joe Biden’s Project 2025 rhetoric. Here’s what the project does and doesn’t call for, and how it squares with Trump’s positions.

Are Trump and Project 2025 connected?

To distance himself from Project 2025 amid the Democratic attacks, Trump wrote on Truth Social that he “knows nothing” about it and has “no idea” who is in charge of it. (CNN identified at least 140 former advisers from the Trump administration who have been involved.)

The Heritage Foundation sought contributions from more than 100 conservative organizations for its policy vision for the next Republican presidency, which was published in 2023.

Project 2025 is now winding down some of its policy operations, and director Paul Dans, a former Trump administration official, is stepping down, The Washington Post reported July 30. Trump campaign managers Susie Wiles and Chris LaCivita denounced the document.

WATCH: A look at the Project 2025 plan to reshape government and Trump’s links to its authors

However, Project 2025 contributors include a number of high-ranking officials from Trump’s first administration, including former White House adviser Peter Navarro and former Housing and Urban Development Secretary Ben Carson.

A recently released recording of Russell Vought, a Project 2025 author and the former director of Trump’s Office of Management and Budget, showed Vought saying Trump’s “very supportive of what we do.” He said Trump was only distancing himself because Democrats were making a bogeyman out of the document.

Project 2025 wouldn’t ban abortion outright, but would curtail access

The Harris campaign shared a graphic on X that claimed “Trump’s Project 2025 plan for workers” would “go after birth control and ban abortion nationwide.”

The plan doesn’t call to ban abortion nationwide, though its recommendations could curtail some contraceptives and limit abortion access.

What’s known about Trump’s abortion agenda neither lines up with Harris’ description nor Project 2025’s wish list.

Project 2025 says the Department of Health and Human Services Department should “return to being known as the Department of Life by explicitly rejecting the notion that abortion is health care.”

It recommends that the Food and Drug Administration reverse its 2000 approval of mifepristone, the first pill taken in a two-drug regimen for a medication abortion. Medication is the most common form of abortion in the U.S. — accounting for around 63 percent in 2023.

If mifepristone were to remain approved, Project 2025 recommends new rules, such as cutting its use from 10 weeks into pregnancy to seven. It would have to be provided to patients in person — part of the group’s efforts to limit access to the drug by mail. In June, the U.S. Supreme Court rejected a legal challenge to mifepristone’s FDA approval over procedural grounds.

WATCH: Trump’s plans for health care and reproductive rights if he returns to White House The manual also calls for the Justice Department to enforce the 1873 Comstock Act on mifepristone, which bans the mailing of “obscene” materials. Abortion access supporters fear that a strict interpretation of the law could go further to ban mailing the materials used in procedural abortions, such as surgical instruments and equipment.

The plan proposes withholding federal money from states that don’t report to the Centers for Disease Control and Prevention how many abortions take place within their borders. The plan also would prohibit abortion providers, such as Planned Parenthood, from receiving Medicaid funds. It also calls for the Department of Health and Human Services to ensure that the training of medical professionals, including doctors and nurses, omits abortion training.

The document says some forms of emergency contraception — particularly Ella, a pill that can be taken within five days of unprotected sex to prevent pregnancy — should be excluded from no-cost coverage. The Affordable Care Act requires most private health insurers to cover recommended preventive services, which involves a range of birth control methods, including emergency contraception.

Trump has recently said states should decide abortion regulations and that he wouldn’t block access to contraceptives. Trump said during his June 27 debate with Biden that he wouldn’t ban mifepristone after the Supreme Court “approved” it. But the court rejected the lawsuit based on standing, not the case’s merits. He has not weighed in on the Comstock Act or said whether he supports it being used to block abortion medication, or other kinds of abortions.

Project 2025 doesn’t call for cutting Social Security, but proposes some changes to Medicare

“When you read (Project 2025),” Harris told a crowd July 23 in Wisconsin, “you will see, Donald Trump intends to cut Social Security and Medicare.”

The Project 2025 document does not call for Social Security cuts. None of its 10 references to Social Security addresses plans for cutting the program.

Harris also misleads about Trump’s Social Security views.

In his earlier campaigns and before he was a politician, Trump said about a half-dozen times that he’s open to major overhauls of Social Security, including cuts and privatization. More recently, in a March 2024 CNBC interview, Trump said of entitlement programs such as Social Security, “There’s a lot you can do in terms of entitlements, in terms of cutting.” However, he quickly walked that statement back, and his CNBC comment stands at odds with essentially everything else Trump has said during the 2024 presidential campaign.

Trump’s campaign website says that not “a single penny” should be cut from Social Security. We rated Harris’ claim that Trump intends to cut Social Security Mostly False.

Project 2025 does propose changes to Medicare, including making Medicare Advantage, the private insurance offering in Medicare, the “default” enrollment option. Unlike Original Medicare, Medicare Advantage plans have provider networks and can also require prior authorization, meaning that the plan can approve or deny certain services. Original Medicare plans don’t have prior authorization requirements.

The manual also calls for repealing health policies enacted under Biden, such as the Inflation Reduction Act. The law enabled Medicare to negotiate with drugmakers for the first time in history, and recently resulted in an agreement with drug companies to lower the prices of 10 expensive prescriptions for Medicare enrollees.

Trump, however, has said repeatedly during the 2024 presidential campaign that he will not cut Medicare.

Project 2025 would eliminate the Education Department, which Trump supports

The Harris campaign said Project 2025 would “eliminate the U.S. Department of Education” — and that’s accurate. Project 2025 says federal education policy “should be limited and, ultimately, the federal Department of Education should be eliminated.” The plan scales back the federal government’s role in education policy and devolves the functions that remain to other agencies.

Aside from eliminating the department, the project also proposes scrapping the Biden administration’s Title IX revision, which prohibits discrimination based on sexual orientation and gender identity. It also would let states opt out of federal education programs and calls for passing a federal parents’ bill of rights similar to ones passed in some Republican-led state legislatures.

Republicans, including Trump, have pledged to close the department, which gained its status in 1979 within Democratic President Jimmy Carter’s presidential Cabinet.

In one of his Agenda 47 policy videos, Trump promised to close the department and “to send all education work and needs back to the states.” Eliminating the department would have to go through Congress.

What Project 2025, Trump would do on overtime pay

In the graphic, the Harris campaign says Project 2025 allows “employers to stop paying workers for overtime work.”

The plan doesn’t call for banning overtime wages. It recommends changes to some Occupational Safety and Health Administration, or OSHA, regulations and to overtime rules. Some changes, if enacted, could result in some people losing overtime protections, experts told us.

The document proposes that the Labor Department maintain an overtime threshold “that does not punish businesses in lower-cost regions (e.g., the southeast United States).” This threshold is the amount of money executive, administrative or professional employees need to make for an employer to exempt them from overtime pay under the Fair Labor Standards Act.

In 2019, the Trump’s administration finalized a rule that expanded overtime pay eligibility to most salaried workers earning less than about $35,568, which it said made about 1.3 million more workers eligible for overtime pay. The Trump-era threshold is high enough to cover most line workers in lower-cost regions, Project 2025 said.

The Biden administration raised that threshold to $43,888 beginning July 1, and that will rise to $58,656 on Jan. 1, 2025. That would grant overtime eligibility to about 4 million workers, the Labor Department said.

It’s unclear how many workers Project 2025’s proposal to return to the Trump-era overtime threshold in some parts of the country would affect, but experts said some would presumably lose the right to overtime wages.

Other overtime proposals in Project 2025’s plan include allowing some workers to choose to accumulate paid time off instead of overtime pay, or to work more hours in one week and fewer in the next, rather than receive overtime.

Trump’s past with overtime pay is complicated. In 2016, the Obama administration said it would raise the overtime to salaried workers earning less than $47,476 a year, about double the exemption level set in 2004 of $23,660 a year.

But when a judge blocked the Obama rule, the Trump administration didn’t challenge the court ruling. Instead it set its own overtime threshold, which raised the amount, but by less than Obama.

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St. Louis American

Taking action to protect Black LGBTQ+ students

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The American Civil Liberties Union is tracking  an alarming 516 bills  aimed at curtailing LGBTQ+ rights in states nationwide. From banning discussions of LGBTQ+ topics in classrooms to prohibiting transgender students from school sports teams aligning with their gender identity, these policies foster an unwelcoming and discriminatory environment for an already vulnerable population.

It’s legislation that could have a disproportionate impact on Black LGBTQ+ students, who face bullying, harassment, and violence due to their race and sexual orientation and/or gender identity. And at a time when  the Black youth suicide rate has more than doubled , protecting these students is a top priority.

Feeling Unsafe, Being Harassed 

Indeed, the results of a  survey released in February  by the Human Rights Campaign found that 42.7% of all Black LGBTQ+ youth and nearly “half (48.8%) of Black transgender and gender-expansive youth, feel unsafe in at least one setting in school.” The report found that 55.9% “of Black LGBTQ+ youth said they’d “been physically or verbally harassed at school in the past 30 days,” and 58.8% of Black transgender and gender-expansive youth said the same.

The survey also revealed 53.3% of Black LGBTQ+ youth screened positive for depression.

Preventing Suicide, Supporting Mental Health

That’s why o​rganizations like  The Trevor Project  — which spearheaded the first national crisis intervention and suicide prevention for LGBTQ+ youth — are arming schools with LGBTQ+ inclusion resources and model suicide prevention policies centered on protecting vulnerable Black students. 

Gabby Doyle, senior manager of state advocacy at The Trevor Project, says policies being passed foster fear and create an unsupportive learning environment.

“These policies range from banning discussions of LGBTQ+ people and topics in the classroom, prohibiting transgender students from playing school sports that align with their gender identity, forcing teachers to out LGBTQ+ students to their families, and even restricting access to life-saving LGBTQ+ online resources like The Trevor Project’s website,” Doyle tells Word In Black. 

The organization’s  2024 U.S. National Survey on the Mental Health of LGBTQ+ Young People  found that the overwhelming majority (90%) of LGBTQ+ young people said their well-being was negatively impacted due to recent politics. The organization’s  research  consistently shows that LGBTQ+ young people with access to safe, inclusive schools and affirming teachers and school staff have lower odds of considering or attempting suicide.

But it’s not just students who are under attack. In April, Texas’ Republican governor Greg Abbott gave a speech saying that gender nonconforming people should not be allowed to teach in the state’s public schools 

“This type of behavior is not OK, and this is the type of behavior that we want to make sure we end in the state of Texas,” Abbott said, according to an audio recording reported  by the Texas Observer .

“Despite what proponents of these harmful policies say, these efforts do not make schools safer or better for any student. Rather, they stop LGBTQ+ students from being able to bring their full selves to school, and prevent school staff and allies from providing them with the support they need,” Doyle says.

Comprehensive Resources for Schools

LGBTQ+ inclusion resources and model suicide prevention policies are being developed to protect these students. Their guidelines, developed with mental health groups, provide strategies like anti-bullying protections, gender-sexuality student groups, and affirmation of all identities.

In 2019, The Trevor Project, along with the American Foundation for Suicide Prevention, the American School Counselor Association, and the National Association of School Psychologists, created the  Model School District Policy on Suicide Prevention . 

The comprehensive guidebook for school administrators and policymakers contains best practices in suicide prevention, intervention, and postvention policies for K-12 schools. 

Additionally,  The Trevor Project’s “Is Your School LGBTQ-Affirming?”  checklist can help educators and school officials determine whether their school adequately supports LGBTQ+ students.

“Making schools inclusive of LGBTQ+ students can provide a life-saving sense of belonging for young people, especially for those who may not live in affirming homes or communities,” Doyle says. 

This can include school district policies that prioritize suicide prevention, zero tolerance policies for anti-LGBTQ+ bullying and harassment, and policies that support and accept students of all identities, including the adoption of affirming programs and extracurricular activities like Gender and Sexuality Alliances (GSAs). Parents and allies can also get familiar with testifying at the local or state level against these efforts.

Above all, “Encourage the lawmakers and school officials in your community to implement policies that support the mental health and well-being of LGBTQ+ young people,” Doyle says.

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Climate Crisis

The damage that can be inflicted by a changing climate makes it one of the most dangerous, yet preventable, risks to human health. The  World Health Organization  projects climate change will cause an additional 250,000 deaths a year from 2030 to 2050. The families most affected by climate change often have the fewest resources and the least ability to adapt in times of crisis.

Working Together to Build Climate Resilience

Thousands of community health centers and free clinics across the U.S. care for millions of our nation’s uninsured or underinsured patients. Yet, more intense hurricanes, historic floods, unprecedented wildfires, increasing heatwaves, and other extreme weather events from climate change threaten their ability to provide care and keep their patients healthy.

The Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health ( Harvard Chan C-CHANGE ) and Americares have collaborated to help protect people on the frontlines of the climate crisis with the Climate Resilience for Frontline Clinics project. Biogen is a founding donor of the project. The three-year effort began with a groundbreaking survey of over 450 clinic staff from 47 U.S. states and territories to identify knowledge gaps and real-world challenges of caring for patients during and after climate shocks. The knowledge gained from that survey helped us create the Climate Resilience for Frontline Clinics Toolkit which provides useful resources for health care providers, patients and administrators at free clinics and community health centers to meet the challenges for health care from climate change.

The Climate Resilience for Frontline Clinics Toolkit

The following resources can be downloaded for your use by clicking on Heat , Wildfires , Hurricanes , Floods or General Guidance and then selecting each document (information or checklist) that you wish to download. Please help us learn more in this project by first filling in the simple form below with the name of your clinic/health center and its location. If you wish, you can also share your name and email so we can alert you to new resources and training opportunities. Then download as many of the PDFs that you wish. The documents are organized for Health Care Providers, Patients and Administrators.

Extreme heat is a particularly deadly form of extreme weather. 

The World Health Organization  tells us that heat waves are considered among the most dangerous of natural hazards but rarely receive adequate attention because their death tolls and destruction are not always accurately assessed and reported. These documents contain critical information you need and actions you and your patients can take to prepare for the challenge of extreme heat. You can view and download English or Spanish versions of the documents by clicking on the links.

• CKD, ESRD, and Heat (English) (Spanish)
• COPD, Asthma, and Heat (English) (Spanish)
• CVD and Heat (English) (Spanish)
• Dementia and Heat (English) (Spanish)
• Diabetes and Heat (English) (Spanish)
• Mental Health Disorders and Heat (English) (Spanish)
• MS and Heat (English) (Spanish)
• Pregnancy and Heat (English) (Spanish)
• How to Establish a Heat Action Plan (English) (Spanish)

Toolkit Cover and Acknowledgement

• Heat Tip Sheet – General (English) (Spanish)
• Heat Tip Sheet – CKD, ESRD (English) (Spanish)
• Heat Tip Sheet – COPD, Asthma (English) (Spanish)
• Heat Tip Sheet – CVD (English) (Spanish)
• Heat Tip Sheet – Dementia (English) (Spanish)
• Heat Tip Sheet – Diabetes (English) (Spanish)
• Heat Tip Sheet – Mental Health Disorders (English) (Spanish)
• Heat Tip Sheet – MS (English) (Spanish)
• Heat Tip Sheet – Pregnancy (English) (Spanish)
• Heat Action Plan – General (English) ( Spanish )
• Heat Action Plan – COPD, Asthma (English) (Spanish)

Administrators

• Heat Alert Plan Guidance and Checklist (English) (Spanish)
• Extreme Heat Operational Guidance (English) (Spanish)
• Extreme Heat Year-Round Guidance (English) (Spanish)
• Extreme Heat Facility Preparedness Guidance (English) (Spanish)
• Extreme Heat Immediate Response Checklist (English) (Spanish) )
• Extreme Heat Communications Templates (English) (Spanish)

Wildfires have many effects on health, especially for individuals with chronic medical conditions.

The changing climate leads to greater periods of drought and extreme heat which increase the likelihood of wildfires. These resources contain critical information you need and actions you and your patients can take to help minimize the impacts of wildfires on health. You can view and download English or Spanish versions of the documents by clicking on the links.

• Wildfires and Health (English) (Spanish)
• Establishing a Wildfire Action Plan (English) (Spanish)
• Wildfire Tip Sheet (English) (Spanish)
• Wildfire Action Plan (English) (Spanish)
• Wildfire Preparedness Checklist (English) (Spanish)
• Wildfire s and Planned Power Outages (English) (Spanish)
• Wildfires Communications Templates (English) (Spanish)
• Facility Repair and Re-Entry after Wildfires (English) (Spanish)

Hurricanes can cause long-term damage to communities

The changing climate can increase the frequency and severity of hurricanes and other storms leading to greater illness, injury and death. The impacts of these storms can last for years due to infrastructure damage and evacuation of communities. These resources contain critical information you need to help you and your patients minimize the impacts of hurricanes. You can view and download English or Spanish versions of the documents by clicking on the links.

• Establishing a Hurricane Action Plan (English) (Spanish)
• Hurricanes and Health (English) (Spanish)
• Hurricane Action Plan (English) (Spanish)
• Hurricane Tip Sheet (English) (Spanish)
• Hurricane Communications Templates (English) (Spanish)
• Hurricane Alert Plan (English) (Spanish)
• Hurricane Immediate Actions Checklist (English) (Spanish)
• Facility Repair and Re-Entry After Hurricanes (English) (Sp a nish)

Floods are a health hazard, especially for individuals with chronic medical conditions.

Flood risk is increasing as a result of climate change, thanks to warmer temperatures and more intense storms. Flood waters can cause injuries and drowning, while damage to homes and difficulty accessing medical care can affect long-term health. These resources contain actions you and your patients can take to help minimize the impacts of floods on human health. You can view and download English or Spanish versions of the documents by clicking on the links.

• Floods and Health (English) (Spanish)
• Establishing a Flood Action Plan (English) (Spanish)
• Flood Tip Sheet (English) (Spanish)
• Flood Action Plan (English) (Spanish)
• Flood Immediate Actions Checklist (English) (Spanish)
• Flood Alert Plan (English) (Spanish)
• Facility Repair and Re-Entry After Floods (English) (Spanish)
• Flood Communications Templates (English) (Spanish)

General Guidance

Climate change-related hazards are harming human health and increasing demand for healthcare services.

The following documents are applicable to all hazards and support clinics in developing the operational capabilities critical for them to stay open and continue to care for their patients during an emergency. You can view and download English or Spanish versions of the documents by clicking on the links.

• Accessing Weather Alerts (English) (Spanish)
• Long-Term Climate Change Resilience (English) (Spanish)
• Power Outage Response (English) (Spanish)

Click on the arrow and watch the video on the Climate Resilience for Frontline Clinics Project.

“We aim to find new ways to protect people most at risk from the climate crisis and advance health equity.”

Dr. Aaron Bernstein, interim director of Harvard Chan C-CHANGE

The Project Story

The project launched with a nationwide survey as well as focus groups with nine pilot clinics in four states: California, Massachusetts, North Carolina and Texas. All of the focus group clinics have experienced recurring emergencies due to the climate crisis. Participating clinics provided information on knowledge gaps , real-world challenges, and opportunities for interventions for their patient populations. They also reviewed the toolkit content and provided valuable feedback that helps us ensure the utility of these resources.

From the data collected from the nationwide survey, we learned that:

• 81% of clinic staff said their clinic experienced some kind of disruption due to extreme weather within the past three years;
• Fewer than 20% of clinic staff feel their clinic is “very resilient” in the face of extreme weather;
• 77% of clinic staff say they do not have the knowledge or tools to implement climate change preparedness at their clinic; and
• More than 80% want education and training to protect their patients from climate-related events.

The team is using this information to create tailored resources for health care providers, staff, and patients on extreme heat, wildfires, hurricanes and floods and working with clinics to put these materials into practice.

“This project is about resilience – not just protecting buildings but protecting people and communities. It is the first of its kind to focus on developing resources for frontline clinics – clinics that serve people disproportionately impacted by the climate crisis,” said Kristin Stevens, Director, Climate and Disaster Resilience

The project will expand across the U.S. to ensure that more clinics providing free or low-cost health care to uninsured or underinsured patients – such as primary, behavioral, emergency, maternity, and specialty care – are ​​better equipped to manage care and protect patients from climate risks.

“It is essential that we work to meet science-based targets that limit global warming to 1.5C, while also addressing the impacts that the climate crisis is having on human health. This pioneering initiative is aimed at protecting patients from the climate health effects happening now, with a focus on those most at risk.”

Biogen Chief Medical Officer Maha Radhakrishnan, M.D.

Participating Clinics and Organizations

California | Massachussetts | North Carolina | Texas

The Free Clinic of Simi Valley

The Free Clinic of Simi Valley in Southern California provides critical medical care to low-income families. Its patients live with the intensifying effects of climate change, including heat and drought.

Lestonnac Free Clinic

Lestonnac Free Clinic , based in Orange County, California, has 13 clinic sites throughout Southern California. In 2020, due to the numerous wildfires, they saw a significant increase in patients coming into the clinic for upper respiratory issues and breathing problems due to the fires.

Massachusetts

MASSACHUSETTS

Cambridge health alliance.

Cambridge Health Alliance works in two safety net community hospitals and multiple primary care centers that serve several diverse communities north of Boston. Its patients are at high risk of heat-related illnesses due to urban heat-island effects, and their neighborhoods are at high risk of flooding due to rising sea levels and worsening storms.

North Carolina

NORTH CAROLINA

The community care clinic of dare.

The Community Care Clinic of Dare in the Outer Banks of North Carolina. In addition to the frequent and intensifying hurricanes that have been occurring, the clinic and patients face challenges from ongoing flooding caused by rising sea levels and increasing temperatures that have a disproportionate effect on their patients who often work outdoors.

Kintegra Health

Kintegra Health , a community health center in North Carolina with over 30 sites. The sites and patients face significant issues from frequent flooding washing out roads and access to healthcare, as well as deteriorating infrastructure, particularly in the rural areas.

The North Carolina Association of Free and Charitable Clinics

The North Carolina Association of Free and Charitable Clinics (NCAFCC) supports 70 free and charitable clinics and pharmacies in the state by coordinating disaster response activities and supporting clinics as they provide healthcare for medically underserved North Carolinians. NCAFCC is feeling the effects of climate change and staff are called on to assist member clinics as climate change has acute and long-term effects on patient care and clinic operations.

Matagorda Episcopal Health Outreach Program (MEHOP)

Matagorda Episcopal Health Outreach Program (MEHOP) provides critical health and behavioral health services for Matagorda County on the east coast of Texas. The facility was evacuated during Hurricane Harvey in 2017 and had many patients and staff members affected by the recent deep freeze. MEHOP is in a rural, underserved area with significant and growing challenges around access to healthcare, degrading infrastructure, and insufficient funds to rebuild after disasters.

San José Clinic

San José Clinic , a charity clinic in Houston, Texas, serves patients directly impacted by Hurricane Harvey and the recent winter storm and related power outages.

Ubi Caritas

Ubi Caritas , a free clinic in Beaumont, Texas, serves communities impacted by multiple hurricanes.

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