# Health Education Development/Settings or Environments

Settings or environments are important contexts for literacy. Literacy is about gaining the knowledge, skills, attitudes and resources that we require to achieve our aspirations. However, our environments often work against our being able to identify our most important aspirations. In fact, they can actively work against our being able to achieve them. Learning to be conscious about how the form of education might actually be oppressing us is a key skill to learn; it is a fundamental literacy as Paulo Freire demonstrated during his life as an educator amongst some of the most oppressed peoples.

## Instructions

Each week we hold a lectorial and a tutorial. The lectorial is a lecture involving audience participation. The tutorials are for discussing the and group activities relating to the topic, and for working on the assignments.
Lectorial
* Read the introductory material for this topic.
* Watch the videos in [this playlist]
* Review Ecological Models of Health Behavior by Lycia Rodrigues. She has done an excellent job of bringing practice into focus with the ecological model. We will be applying some of this thinking in our lectorial explorations.
* Begin your reading of Chapter Four, 'Health behaviour theories, models and frameworks', in Health education: Theoretical concepts, effective strategies and core competencies.
* Attend the lectorial or view the recording
* Start your critical essay by reviewing the requirements here.
Tutorial
* Review the activities for Team 3 (page 47) and Team 4 (page 60). The team will have already been preparing; so, this instruction is for everyone else.
* Attend the tutorial and be prepared to participate in the session in in the evaluation of the sessions.

## What is the importance of Settings or Environments for HED?

Think of your 'favourite' World War II movie. You may have another war with which you are more familiar. But, please focus on this era for a moment. Imagine the massive shifts that would have occurred when many millions of men moved from their homes and towns to engage an enemy very much like themselves in half a dozen theatres of war around the world. Who took their places at work, in the community and at home? What would it be like to return? Someone who once walked behind a horse and plow in England returns to find everything mechanised which allowed many 'land girls' to produce even more food than some men had produced before the war. What would a society have to do to create a supportive environment in which these millions of demobilised men might learn how to return to civilian life after all of the killing and destruction? Well, while the numbers may not be as large, this is still a current issue for us today. Whole families and communities are moving to Australia from refugee camps having fled an apocalypse in their life. And, there are the men and women returning home from the various zones in which the 'War on Terror' is being waged. What are the dynamically related factors that influence the prerequisites for health and what are the contexts in which we might gain health literacy or undertake healthy learning? That is what this topic will begin to explore. For instance, the message of the poster to the right seems to be that home and health may be obtained through an engagement with arts and crafts. There was and remains a rather large movement advocating this approach. Is it an viable option? In fact, Occupational Therapists once were heavily involved in this sort of work. That was one of meanings of occupation or to be occupied. Interestingly, when the shock of the Industrial revolution, was disseminating whole communities and regions, William Cobbett advocated and wrote about much the same thing in the early 1830s. We should not be quick to dismiss the possibilities; but, we, like Cobbett, should be alert to the social, cultural, economic and political context in which these activities would take place.

## Background

Everything we do happens within a context that shapes our experience. We often forget this until the environment is no longer supportive or until we are responsible for creating the supportive environment. Each type of setting, whether associated with education, employment, community, recreation and so forth, shapes the possibilities of the environment. In other words, there is an 'ecology' to settings and contexts (Stokols 1996). This 'ecology' is comprised of dynamic interchanges that somehow maintain themselves in can be an amazing fashion. Yet, things do change through time and we must be aware of the processes involved in changing a setting or an environment associated with a site of various activities such as a tertiary institution (Schreiner & Anderson 2005). So, we will take an ecological approach in considering these issues and we will be alert to the way in which ethnicity, gender or class might influence or be influenced by the setting (Perkins, Crim, Silberman & Brown 2004). We will want to support the resiliency, the ability to bounce back, of individuals and groups by ensuring that the environment puts a spring in their step rather than pulling them down with just one more difficulty to overcome (Blundo 2001). McLeroy, Bibeau, Steckler and Glanz (1988:355), extending Uri Broffenbrenner's model, proposed that we need to consider a number of aspects to settings and environments and their impacts on people and processes such as: (a) intrapersonal factors, (b) interpersonal processes, (c) institutional factors, (d) community factors and (e) public policy. The Sundsvall Statement put it in somewhat plainer language:
    In a health context the term supportive environments refers to both the physical and the social aspects of our surroundings. It encompasses where people live, their local community, their home, where they work and play. It also embraces the framework which determines access to resources for living, and opportunities for empowerment. Thus action to create supportive environments has many dimensions: physical, social, spiritual, economic and political. Each of these dimensions is inextricably linked to the others in a dynamic interaction. Action must be coordinated at local, regional, national and global levels to achieve solutions that are truly sustainable. (emphasis original, WHO 1991:3)
References and Resources
    Blundo, R. (2001) Learning strengths-based practice: Challenging our personal and professional frames. Families in Society: The Journal of Contemporary Human Services. 82(3):296-304.
    Perkins, D.D., Crim, B., Silberman, P. and Brown, B.B. (2004) Community development as a response to community-level adversity: Ecological theory and research and strengths-based policy. In, Maton, K I., Schellenbach, C. J., Leadbeater, B. J. and Solarz, A. L. (Eds) Investing in children, youth, families, and communities: Strengths-based research and policy. Washington, DC: American Psychological Association, pp. 321-340.
    McLeroy, K.R., Bibeau, D., Steckler, A. and Glanz, K. (1988) An ecological perspective on health promotion programs. Health Education Quarterly. 15(4):351-377.
    Schreiner, L.A. and Anderson, E.C. (2005) Strengths-based advising: A new lens for higher education. NAACADA Journal 25(1):20-29.
    Stokols, D. (1996) Translating social ecological theory into guidelines for community health promotion. American Journal of Health Promotion. 10(4):282-298.
    WHO (1991) Sundsvall Statement on Supportive Environments, 9-15 June 1991, Sundsvall, Sweden. Geneva: World Health Organization.

## Learning Outcomes

Upon completion of this topic, through your own investigations, group preparation, tutorial participation and lectorial explorations, you should be able to:
* Single out key documents relating to and outline the historical development of an adequate understanding of the importance of settings or environments for health education development (e.g., charters, statements and declarations).
* Identify the various proponents of an ecological approach to health promotion, distinguish the key characteristics of this approach in terms of ‘systems thinking’ and demonstrate how these characteristics can inform health education practice.
* Categorize the various settings that have been identified in terms of the capacity to support cooperative learning and propose ways that these capacities can be enhanced to promote resiliency.
* Propose arguments that might persuade decision-makers about the importance of providing appropriate infrastructure resources for achieving appropriate learning outcomes among various class, ethnic and gender-based groups.