Freedman Ariela M, Echt Katharina V, Cooper Hannah L F, Miner Kathleen R, Parker Ruth
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Health Promot Pract. 2012 Sep;13(5):648-56. doi: 10.1177/1524839911432928. Epub 2012 Mar 27.
Health education and behavior change interventions typically pay little attention to the intervention's instructional foundation. Combining the fields of health literacy, cognitive psychology, and adult learning theory, this article provides an integrative scientific approach, called the BEAN (Better Education and iNnovation) model, to creating an instructional foundation based on how individuals acquire knowledge and skills. The article uses a case study example from an adult literacy center's health literacy class to explore how environmental factors and instructional strategies can be applied to health education and behavior change interventions. Data for this case study were derived through 20 hours of classroom observation and qualitative interviews with 21 adult education students and 3 instructors. Results provide practical examples of environmental factors and instructional strategies designed to facilitate learning, such as fostering autonomy, activating prior knowledge, and fostering perspective change. Results also describe the resulting health behavior changes of students attending the health literacy class, such as increased medication adherence and physical activity, improved nutritional habits, and increased question asking of health practitioners. This article serves as a first step to encouraging researchers and educators to consider the importance of drawing on cognitive psychology and theories of adult learning to create a scientifically based instructional foundation for health behavior change programs. Additionally, by drawing on the expertise of adult educators well versed in the science of instructional design, this article also demonstrates that the adult education classroom is an excellent setting for conducting health education and behavior change interventions.
健康教育与行为改变干预措施通常很少关注干预措施的教学基础。本文结合健康素养、认知心理学和成人学习理论领域，提供了一种综合科学方法，即BEAN（更好的教育与创新）模型，用于根据个体获取知识和技能的方式创建教学基础。本文以一个成人识字中心的健康素养课程为例，探讨环境因素和教学策略如何应用于健康教育与行为改变干预措施。该案例研究的数据来自20小时的课堂观察以及对21名成人教育学生和3名教师的定性访谈。研究结果提供了旨在促进学习的环境因素和教学策略的实际示例，例如培养自主性、激活先前知识以及促进观念转变。研究结果还描述了参加健康素养课程的学生所产生的健康行为变化，如药物依从性和身体活动增加、营养习惯改善以及向健康从业者提问增多。本文迈出了第一步，鼓励研究人员和教育工作者考虑借鉴认知心理学和成人学习理论，为健康行为改变项目创建基于科学的教学基础。此外，通过借鉴精通教学设计科学的成人教育工作者的专业知识，本文还表明成人教育课堂是开展健康教育与行为改变干预措施的绝佳场所。
