Barriers of Health Education from the Perspective of School Health Trainers: A Qualitative Study

Document Type : Original Research

Authors
1 Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
2 Department of Midwifery, Faculty of Nursing & Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
3 Health Network of Sanandaj, Kurdistan University of Medical Sciences, Sanandaj, Iran
Abstract
Aims: Schools health education can ensure the health of society and encourage health behaviors among the students. This study was carried out to explain the barriers of health education from the viewpoint of the school health trainers, using qualitative content analysis.

Participants & Methods: This qualitative study was conducted at the schools of Sanandaj, located in the west of Iran in 2016. Using purposive sampling, 15 school health trainers with health education experience were included in the study. The data were collected through individual interview, group discussion, observation, and field notes, and were analyzed by conventional content analysis. To ensure the accuracy and consistency of data, the acceptability, confirmability, and transferability parameters were taken into account.

Findings: The results yielded 5 major categories, including “shortage of educational facilities”, “poor educational planning”, “student’s challenges”, “trainer’s problems,” and “poor administrative system”.

Conclusion: Considering the barriers to health education programs at schools, authorities are required to pay more attention to promotion of health and inter-sectoral and extra-sectoral collaboration, as well as emphasizing the close relationship of home and school.

Keywords

Subjects


  1. 1. Kardia S, Wang C. The role of health education and behavior in public health genetics. Health Educ Behav. 2005;32(5):583-8.
    2. Fallahi A, Ghofranipour F, Ahmadi F, Malekafzali B, Hajizadeh E. Challenges of Iranian adolescents for preventing of dental caries. Iranian Red Crescent Medical Journal. 2014;16(9):1-7.
    3. Zarei F, Ghahremani L, Khazaee-Pool M, Keshavarz Mohammadi N. Exploring The Strengths, Challenges and Improvement Strategy For Health-Promoting Schools From School Health Experts Iran J Health Educ Health Promot. 2017;5(3):240-50.
    4. Al-Alwan A, Mahasneh A. Teachers’ Self-efficacy as Determinant of Students’ Attitudes toward School: A study at the School Level. Review of European Studies. 2014;6(1):172-9.
    5. Buerlein J. Promoting children’s oral health: a role for school nurses in prevention, education, and coordination. . NASN School Nurse. 2010;25:26-9.
    6. Helam Seresht P, Delpisheh E. School health. Tehran2005.
    7. Watt RG. Strategies and approaches in oral disease prevention and health promotion. Bull World Health Organ. 2005;83:711-8.
    8. Roy Mayer G. Preventing antisocial behavior in the schools. J Appl Behav Anal. 1995;28(4):467–78.
    9. Derryberry M. Today’s Health Problems and Health Education. Am J Public Health. 2004;94(3):368–71.
    10. Hafezi A. Comparing environmental health of school with approach of promoting level of national education in elementary-girl school with and without health educator. . Quarterly Journal of Educational Innovations. 2011;43(11):164-78.
    11. Barangi A. The Role of schools in informing youth about the phenomenon of addiction2013.
    12. Kamalikhah T, Rahmati-Najarkolaei F, Karimi M. Barriers of Reproductive Health Education in Schools. Barriers of reproductive
    health education in schools Zahedan. 2011;14(2):71-5[Perasion].
    13. McClary King K, Ling J. Results of a 3-year, nutrition and physical activity intervention for children in rural, low-socioeconomic status elementary schools. HEALTH EDUCATION RESEARCH. 2015;30(4):647–59.
    14. Raman S, Nicholls R, Pitakaka F, Gapirongo K, Hou L. Identifying and overcoming barriers to adolescent sexual and reproductive health in the Solomon Islands: perspectives and practices of health, education and welfare workers. Pacific Journal of Reproductive Health. 2015;1:4-13.
    15. Kubo F, de Paula J, FL M. Teachers' views about barriers in implement oral health education for school children: a qualitative study. Brazilian Dental Science. 2014;17(4):65-73.
    16. Abolqasemi N, Merqhatikhoi E, Taghdisi M. Iranian students explain sexual education from the perspective of primary health educators. Faculty of Health and Medical Research Institute. 2011;8(2):27-39[Perasion].
    17. AhmadizadehFini E, Madani A, Alizadeh A, Ghanbarnejad A. Effect of Peer Education on Health Promoting Behaviors of Junior High School Students. Iranian Journal of Health Education & Promotion. 2015;3(2):105-15.
    18. Hsieh H, Shannon S. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-88.
    19. Rezaii Sharif A, Gazi Tabatabaei M, Hejazi E, Ejei J. Investigation of the Viewpoint of Students about School Bonding: A Qualitative Study.
    Journal of Psychology61. 2012;1:16-35[Persian].
    20. Polit D, Beck C. Essential of nursing research ED t, editor. Philadelphia: Lippincott Williams Wilkins Co; 2006.
    21. Kvale S, 1996).. InterViews—An introduction to qualitative research interviewing. Thousand Oaks, CA: Sage.1996.
    22. Mayring P. Qualitative content analysis. . Forum: Qualitative Social Research. 2000;1(2):1-10.
    23. Graneheim U, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12.
    24. Kranz A, Rozier R, Zeldin L, Preisser J. Oral health activities of early head start teachers directed toward children and parents. J Public Health Dent. 2011;71:161-9.
    25. Hendrickson R, Huebner C, Riedy C. Readability of pediatric health materials for preventive dental care. BMC Oral Health. 2006;16(6):14.
    26. Zarezadeh Y, Fallahi A, Nemat Shahrbabaki B, Hashemian M, Ghalvazi R. Exploring the barriers to health education from the perspective of the personnel of urban healthcare centers in Iran. health scope. in press.
    27. Ramroop V, Wright D, Naidu R. Dental health knowledge and attitudes of primary school teachers toward developing dental health education. West Indian Med J. 2011;60:576-80.
    28. De Castilho A, Mialhe F, Barbosa T, Puppin-Rontani R. Influence of family environment on children’s oral health: a systematic review. J Pediatr. 2013;89:116−23.
    29. Smith B, Potts-Datema W, Nolte A. Challenges in teacher preparation for school health education and promotion. Promot Educ. 2005;12:162-4.
    30. Mehmet A, Cinar O, Sutcigil L, Dovyap Congologlu E, Haciomeroglu B, Canbaz H, et al. Communication Skills Training For Emergency Nurses. Int J Med Sci. 2011;8(5):397–401.
    31. Mohlabi D, Van Aswegen E, Mokoena J. Barriers to the successful implementation of school health services in the Mpumalanga and Gauteng provinces. SA Fam Pract. 2010;52(3):249-54.
  2. Kardia SL, Wang C. The role of health education and behavior in public health genetics. Health Educ Behav. 2005;32(5):583-8. [Link] [DOI:10.1177/1090198105278560]
  3. Fallahi A, Ghofranipour F, Ahmadi F, Malekafzali B, Hajizadeh E. Challenges of Iranian adolescents for preventing of dental caries. Iran Red Crescent Med J. 2014;16(9):e15009. [Link] [DOI:10.5812/ircmj.15009]
  4. Zarei F, Ghahremani L, Khazaee Pool M, Keshavarz Mohammadi N. Exploring the strengths, challenges and improvement strategy for health-promoting schools from school health experts: A qualitative study. Iran J Health Educ Health Promot. 2017;5(3):240-50. [Persian] [Link] [DOI:10.30699/acadpub.ijhehp.5.3.240]
  5. Al-Alwan A, Mahasneh A. Teachers' self-efficacy as determinant of students' attitudes toward school: A study at the school level. Rev Eur Stud. 2014;6(1):171-9. [Link] [DOI:10.5539/res.v6n1p171]
  6. Buerlein J. Promoting children's oral health: A role for school nurses in prevention, education, and coordination. NASN Sch Nurse. 2010;25(1):26-9. [Link] [DOI:10.1177/1942602X09353053]
  7. Helm Seresht P, Delpisheh E. Health of schools. 2nd Edition. Tehran: Chehr; 2005. [Persian] [Link]
  8. Watt RG. Strategies and approaches in oral disease prevention and health promotion. Bull World Health Organ. 2005;83(9):711-8. [Link]
  9. Roy Mayer G. Preventing antisocial behavior in the schools. J Appl Behav Anal. 1995;28(4):467-78. [Link] [DOI:10.1901/jaba.1995.28-467]
  10. Derryberry M. Today's health problems and health education. Am J Public Health. 2004;94(3):368-71. [Link] [DOI:10.2105/AJPH.94.3.368]
  11. Hafezi A. Comparing environmental health of school with approach of promoting level of national education in elementary-girl school with and without health educator. Q J Educ Innov. 2011;43(11):164-78. [Persian] [Link]
  12. White J, Bagnall A, Trigwell J. Health trainers making a difference to mental health and wellbeing. Perspect Public Health. 2015;135(3):130-2. [Link] [DOI:10.1177/1757913915579131]
  13. Kamalikhah T, Rahmati Najarkolaei F, Karimi M. Barriers of reproductive health education in schools. Zahedan J Res Med Sci. 2012;14(2):71-5. [Persian] [Link]
  14. King KM, Ling J. Results of a 3-year, nutrition and physical activity intervention for children in rural, low-socioeconomic status elementary schools. Health Educ Res. 2015;30(4):647-59. [Link] [DOI:10.1093/her/cyv029]
  15. Raman Sh, Nicholls R, Pitakaka F, Gapirongo K, Hou L. Identifying and overcoming barriers to adolescent sexual and reproductive health in the Solomon Islands: Perspectives and practices of health, education and welfare workers. Pac J Reprod Health. 2017;1(6):282-91. [Link]
  16. Kubo FMM, De Paula JS, Mialhe FL. Teachers' views about barriers in implement oral health education for school children: A qualitative study. Braz Dent Sci. 2014;17(4):65-73. [Link] [DOI:10.14295/bds.2014.v17i4.1031]
  17. Hempler NF, Pals RAS, Pedersbæk L, DeCosta P. Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study. BMC Psychiatry. 2018;18(1):353. [Link] [DOI:10.1186/s12888-018-1924-3]
  18. Ahmadizadeh Fini E, Madani A, Alizadeh A, Ghanbarnejad A, Aghamolaei T. Effect of peer education on health promoting behaviors of junior high school students. Iran J Health Educ Health Promot. 2015;3(2):105-15. [Persian] [Link]
  19. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-88. [Link] [DOI:10.1177/1049732305276687]
  20. Rezaii Sharif A, Gazi Tabatabaei M, Hejazi E, Ejei J. Investigation of the viewpoint of students about school bonding: A qualitative study. J Psychol. 2012;16(1):16-35. [Persian] [Link]
  21. Polit DF, Beck CT. Essentials of nursing research: Methods, appraisal, and utilization. Philadelphia: Lippincott Williams & Wilkins; 2006. [Link]
  22. Kvale S. Interviews: An introduction to qualitative research interviewing. Thousand Oaks CA: Sage Publications; 1996. [Link]
  23. Mayring P. Qualitative content analysis. Forum Qual Soc Res. 2000;1(2):Art. 20. [Link]
  24. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12. [Link] [DOI:10.1016/j.nedt.2003.10.001]
  25. Kranz AM, Gary Rozier R, Zeldin LP, Preisser JS. Oral health activities of early head start teachers directed toward children and parents. J Public Health Dent. 2011;71(2):161-9. [Link] [DOI:10.1111/j.1752-7325.2011.00245.x]
  26. Hendrickson RL, Huebner CE, Riedy CA. Readability of pediatric health materials for preventive dental care. BMC Oral Health. 2006;6:14. [Link] [DOI:10.1186/1472-6831-6-14]
  27. Zarezadeh Y, Fallahi A, Nemat Shahrbabaki B, Hashemian M, Ghalvazi R. Perspective of Health Care Providers about Barriers of Instructional Programs: A Qualitative Study. Health Scope. 2017;6(3):15116- 25. [Link] [DOI:10.5812/jhealthscope.15116]
  28. Ramroop V, Wright D, Naidu R. Dental health knowledge and attitudes of primary school teachers toward developing dental health education. West Indian Med J. 2011;60(5):576-80. [Link]
  29. Castilho AR, Mialhe FL, Barbosa Tde S, Puppin-Rontani RM. Influence of family environment on children's oral health: A systematic review. Jornal de Pediatria (Rio J). 2013;89(2):116-23. [Link] [DOI:10.1016/j.jped.2013.03.014]
  30. Smith BJ, Potts-Datema W, Nolte AE. Challenges in teacher preparation for school health education and promotion. Promot Educ. 2005;12(3-4):162-4. [Link] [DOI:10.1177/10253823050120030116]
  31. Ak M, Cinar O, Sutcigil L, Congologlu ED, Haciomeroglu B, Canbaz H, et al. Communication skills training for emergency nurses. Int J Med Sci. 2011;8(5):397-401. [Link] [DOI:10.7150/ijms.8.397]
  32. Mohlabi DR, Van Aswegen EJ, Mokoena JD. Barriers to the successful implementation of school health services in the Mpumalanga and Gauteng provinces. S Afr Fam Pract. 2010;52(3):249-54. [Link] [DOI:10.1080/20786204.2010.10873983]