Anyone designing health education programmes (including info on mental AND physical health, behaviour change AND critical thinking) in HE students?

I am currently doing a systematic review of health education programmes among music students in higher education (i.e. conservatoire students), but the way in which I define such a programme is essential to what papers I include.

Health education initiatives were eligible if they represented stand-alone interventions or were part of wider health promotion programmes. Health education programmes were defined according to WHO (1998) and had to be any planned activity or set of activities aimed at increasing health literacy and developing life skills conducing to health (e.g. decision making, problem solving, critical thinking, interpersonal skills, stress management, coping with emotions). The content of such programmes could comprise counseling, teaching, training or other educational processes such as guided group discussions or behavioural modification strategies (Zhu, Ho, & Wong, 2013). Such programmes could be part of or separate from the formal curriculum, yet taking place in a formal education music institution (college, high-school, conservatoire or university, not clinics) incorporating any relevant health-related content (focusing on psychological and/or physical issues), multi-component or formed of a single session, of any frequency and/or length and provided via any delivery method (i.e. face-to-face, via telephone or internet). Only studies focusing on universal preventative interventions were included (i.e. ‘a measure that is desirable for everybody in the eligible population’ [Mrazek & Haggerty, 1994]).

Now, according to this definition, health education (unlike health promotion) should be aimed primarily at outcomes such as increasing knowledge and/or awareness, changing attitudes, beliefs, perceived responsibility, self-efficacy, as well as training relevant skills/abilities such as critical thinking, decision-making or problem-solving. It should not necessarily or on its own be aimed, at changing actual health-related outcomes such as reducing risk of injury or lowering depression/anxiety - for such outcomes, we are talking about health promotion (which incorporates health education but goes beyond it, also encompassing changing the broader environment and ensuring relevant services are in place). However, many authors use health promotion when they only mean health education.

I have two questions:

1. Where should I draw the line given that using such a broad definition for health education programmes (aimed at developing health literacy and life skills) means I need to include both evaluations of formal health courses (that come in the traditional format of a series of lectures and seminars) and evaluations of interventions involving group discussions, more applied sessions and more focused training of specific skills, albeit with music students in a higher education institution? They both fit into the WHO definition!

2. Given that so many authors use health promotion and health education interchangeably and that only one evaluation of a health education programme looked at knowledge, attitudes and beliefs while all the others looked at health-related outcomes (although all were described as health courses), can I include all these outcomes as part of my systematic review? After all, I am looking at the effectiveness of health education programmes with regards to any outcomes! (health literacy and attitude change on one hand, and changes in actual health outcomes on the other hand)

Many thanks! I am really curious to read your views on the above!

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Recently, I have been approached by a colleague who wishes to develop a 'health communication' programme. It's not a term that I have come across many times before. Given it's very broad remit - is it not health promotion/public health/community health (with health education added) by another name? Wikepedia gives a decent enough account of it - and I can see that there are some specifics - such as health literacy and use of media - but they are covered under the umbrella of health promotion/education too. Does anyone have a different spin on this?

Dean

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