08. Health and Wellbeing Education
Paper
Cross-Professional Collaboration in Health and Well-being - Teacher Students and Public Health Nurse Students' Reflections on Health Information
Kristin Walseth, Siv Lund, Tonje Fjogstad Langnes, Judith Bratten
OsloMet - storbyuniversitetet, Norway
Presenting Author: Walseth, Kristin
Introduction
In 2020, the Norwegian curriculum was renewed and introduced a new cross-curricular theme ‘Public Health and Life Skills’ (PHLS) into schools. We have in this project focused on the potential of cross-professional cooperation when teaching PHLS in school. Specifically, we have studied how teacher students and public health nurse students discuss what they consider to be the most important sources of health information in their lives and their reflections on the different sources' trustworthiness.
The research questions asked is: Which sources of health information are considered central and valid by teacher students and public health nurse students? And which understandings of health are expressed by the students?
There are limited knowledge on the potential of cross-professional teaching of health and well-being in the Norwegian context. However, international research show that the introduction of similar subjects/topics in schools has resulted in an increased collaboration with external health organizations (Kirk, 2020; O'Higgins et al., 2007). In the Norwegian context, the school health service is a central actor with a purpose to facilitate for a good social milieu in schools and should contribute to students' health, preventing illness and injuries (Helsedirektoratet, 2021).
Research shows that school nurses play an important role in school, particulalry when working with students in vulnarable situations (Federici et al., 2021; Kvarme, 2017), and the importance of cross-professional collaboration is emphasized as important. At the same time, research shows that there can be challenges in cross-professional collaboration for teachers and school nurses partly because of the professions' different understandings of knowledge and different epistemologies. While the teacher profession seems to value personal knowledge and experience as most important, the nurse profession emphasize scientific knowledge (Bråten & Strømsø, 2005; Karseth & Nerland, 2007; Nerland & Karseth, 2015).
Previous research on the two professions understandings of health is therefore of interest to this project. Health is a complex concept, and studies show that teachers and school nurses understanding of health has consequences for their work. A pathogene understanding of health seem to dominate the professions practices, despite recent research emphasizinng salutogene and critical perspectives on health as more conducive approaches in schools (Mong & Standal, 2019; Quennerstedt, 2019; Samdal, 2021).
Methodology, Methods, Research Instruments or Sources UsedMethod
This paper is part of a larger study that follows teacher students over four semesters at campus and during school practicum. The findings presented here are based on two different data sources. First, the students were asked to draw a map of places where they learn about health. Secondly, these maps were discussed in cross-professional groups (teacher students and public health nurse students). The group discussions were guided by questions developed by the researchers. We chose to used visual methods (drawings) as a tool to facilitate cross-professional discussions about health. By drawing the maps, the students become central in the research process by producing their own visual data that can 'speak on their behalf' (Azzarito & Kirk, 2013). Visual methods are often highlighted as particular useful when discussion sensitive topics with young people because pictures/drawings can help young people communicate thoughts, feelings and ideas that can be difficult to put into words (Katzew & Azzarito, 2013).
The data material consists of 51 drawings of health maps and voice recording of 8 group discussions. The interviews have been coded inductively, and the researchers have developed thematic codes together (Bryman, 2016). The data material has been further analyzed through previous research on the two professions, their understanding of health and knowledge. The researchers have worked together and discussed strategies and experiences from the data collection process and analysis throughout the whole study. In this way, we have strengthened the study's trustworthiness through research triangulation (Twining et al., 2017).
Conclusions, Expected Outcomes or FindingsResults/discussion
The study shows that there are both similarities and differences between the groups concerning what they consider to be important and trustworthy sources of health information. The students agree that health information they receive from education institutions and official webpages like the Institute of Public Health are credible. In addition, the students emphasize the advantage of being able to search information about sensitive topics anonymously online.
Both groups of students emphasize the importance of research-based knowledge, but in contrast to the public health nurse students, the teacher students argued that knowledge that is not research based can also be useful sources for health information, and emphasized that influencers on social media has become important sources of health information. This reflects a difference between the professions where teachers emphasize personal reflective knowledge above research-based knowledge.
The study does also show that the public health nurses give weight to a holistic understanding of health, while teacher students emphasize physical health, exercising and nutrition when drawing health maps and discussing them. We argue that a cross-professional cooperation in PHLS will be useful because a critical societal perspective on health is a central part of the public health nurse education. This perspective emphasize that pupils’ health depends on social, cultural, and political factors. The perspective can counteract a dominating healthism ideology that communicate that youth are responsible for their own health, and that good health is easy to attain through individual effort, discipline and moral.
ReferencesReferences
Bråten, I., & Strømsø, H. I. (2005). The relationship between epistemological beliefs, implicit theories of intelligence, and self-regulated learning among Norwegian postsecondary students. British Journal of Educational Psychology, 75(4)(Pt 4), 539-565.
Casey, D. (2007). Nurses' perceptions, understanding and experiences of health promotion. J Clin Nurs, 16(6), 1039-1049.
Federici, R. A., Helleve, A., Midthassel, U. V., Cecilie, B. A., & Alne, R. (2021). Et lag rundt eleven: økt helsesykeforståelse av helsefremming i sykepleie (Rapport: 2021:23 ). f. o. u. Nordisk institutt for studier av innovasjon.
Karseth, B., & Nerland, M. (2007). Building professionalism in a knowledge society: examining discourses of knowledge in four professional associations. Journal of Education and Work, 20(4), 335-355.
Katzew, A., & Azzarito, L. (2013). From media images to body narratives: photo elicitation as a method for triggering young people’s “body talk”. In (pp. 78-91). Routledge.
Kirk, D. (2020). Turning outsourcing inside-out? The case of the mindfulness in schools project. Discourse: Studies in the Cultural Politics of Education, 41(2), 238-250.
Mong, H. H. (2019). «I kroppsøving så tenker jeg nok mest på det fysiske» – En studie om kroppsøvingslæreres forståelse og undervisning om helse i faget. Journal for Research in Arts and Sports Education, 3(2).
Mong, H. H., & Standal, Ø. F. (2019). Didactics of health in physical education – a review of literature. Physical Education and Sport Pedagogy, 24(5), 506-518.
Quennerstedt, M. (2019). Healthying physical education - on the possibility of learning health. Physical Education and Sport Pedagogy, 24(1), 1-15.
Samdal, G. B. (2021). Sykepleiere må ha kunnskap om helsefremmende arbeid på individ- og samfunnsnivå. Sykepleien, 109(86988).
Twining, P., Heller, R. S., Nussbaum, M., & Tsai, C.-C. (2017). Some guidance on conducting and reporting qualitative studies. Computers & Education, 106, A1-A9.
08. Health and Wellbeing Education
Paper
Cooperation Between School and Parent to Promote Parental Health Literacy
Dace Kravale, Iveta Ķestere
University of Latvia
Presenting Author: Kravale, Dace
Health literacy is a concept widely used in the healthcare system, but not sufficiently explained in education settings. Concept of health literacy includes and explains the relationship between an individual's level of literacy and his/her ability to maintain, improve and participate in his/her own and health care of others. Obviously, health literacy is related to literacy – discovering, understanding, evaluating and using information to make everyday life decisions about health care, disease prevention and health promotion in order to maintain and/or improve quality of life over the life course. Health literacy is being put into practice gradually, linked to the overall level of health education in society as a whole. As health literacy studies in European countries show, the overall level of health literacy varies from country to country and from social group to social group, currently exacerbated by the presence of pandemics and viral diseases. Scholars argue that the social determinants of health literacy need to be taken into account when developing public health strategies to improve health equity in Europe, stressing that limited health literacy is a challenge for health policy and practice across Europe. In this context, parental health literacy is challenged by: a) the constraints of the pandemic, where parents are in closer contact as usually with their children but are not always able to respond appropriately to their child's needs (especially for younger children); b) changes in the general health system, where each person's individual responsibility for their own and their family's health is increasing; c) parental health literacy is seen as an important competence in monitoring or supervising the health status of their child: children are dependent on parental care and can suffer in situations where parents' own education and health knowledge are insufficient. Research confirms the links between parental health, educational attainment and children's learning achievements, underlining the importance of parental competence in health-related issues. Schools, with education at their core, can be an important tool for improving health literacy not only for children but also for parents. At least this was the hypothesis of our study.
The objective of our study is to find out the views of both parties (parents and educators) on the current situation of parent health literacy in Latvia and possibilities of school-parent cooperation in health literacy. Our research is based on literature on health literacy theories, health literacy empirical studies, and policy documents related to health literacy. Our empirical study was led from September, 2021 to May, 2022 based on focus group discussions and interviews. For empirical study were set three main questions: 1) what is parents' understanding of health literacy? 2) what factors in school-parent cooperation promote, limit or hinder parental health literacy? 3) how can school-parent cooperation in the development of parental health literacy be improved? The results of the study show mixed perceptions of health literacy among parents, teachers and school management, supporting the assumption that health literacy in educational settings of Latvia is just a developing process and requires systemic cooperation to promote health literacy and a clearly defined terminology for health literacy.
Methodology, Methods, Research Instruments or Sources UsedThis is a case study, multiple-case design, in which two cases or schools are analysed at the same time, assessing school-parent collaboration in health literacy and participants' perceptions of health literacy. According to the research design, the following research methods were chosen: a) focus group discussions with a representative sample of parents and teachers; b) interviews with school administrators; c) data collection and analysis. The sample was drawn using purposive and convenience sampling and respondents who represents the educational environment. To ensure scientific strength, triangulation of data is used, gaining insight into the phenomenon under study - school-parent cooperation in the process of parental health literacy - from teachers, parents and school administrators. The study analyses six sub-cases or three groups from each school - six teachers, six parents and the group of school management. The main criteria for selecting the participants were their relevance to the educational environment and their voluntary agreement to participate in the study. The following selection criteria were collected: age, sex, place of residence, location of educational institution, age of children, health literacy information, namely, have been familiar with the term or have heard it for the first time.
Participants received an information letter outlining the topic, objectives and process of the study, giving all participants the opportunity to prepare for a discussion on parental health literacy and school-parent cooperation. Focus group discussions and interviews were organised remotely on Zoom platform and lasted 2x 40 minutes. The participants are 25 women aged 37-43 and 1 man, aged 45. Six (6) teachers are employees of a comprehensive school and six (6) - in a music school. The parent group is represented by six (6) mothers whose children are in grades 1-12 in the comprehensive school and six (6) mothers whose children are in grades 1-9 in the music-oriented school. Five of the 12 mothers in the study are pedagogues by profession, so during the interview the parent-mothers also reflected as educators. Data analysis was carried out using the principles of thematic analysis, highlighting the analysis of themes from the interviews and revealing themes that summarise the content of the data. The thematic analysis process resulted in 276 terms: School management - 32, parents - 42, teachers - 154, which were summarised in 18 sub-themes, forming 6 themes, according to which the material from the focus group discussions and interviews were analysed.
Conclusions, Expected Outcomes or FindingsCurrently, the problems are in the different understandings of health literacy by parents and teachers, which further create different mutual expectations, leading to confusion about who is responsible for what, what kind of health literacy information would be appropriate. In order to improve the understanding of health literacy and to ensure that collaboration in educational settings works to the benefit of all parties, there is a need for both a structured terminology for health literacy and for the development of guidelines for health literacy in educational settings.
The results suggest that there is a link between individuals - both parents and teachers - relationships, self-perception, family psycho-emotional climate and other sensitive issues, and cooperation in health literacy. Parental health literacy determines how the parent as an individual communicates within the family, how health literacy is shaped within the family system, what values the parent tries to instil in the children and what health standards are followed. The same can be applied to teachers, whose professional ethics impose additional responsibilities and tasks in health literacy, both in educating pupils and in communicating information to parents.
The experience of other countries in health education and the process of parental involvement may be more dynamic and have a longer history, but the discussions of the survey respondents in Latvia highlight the problems of parent-teacher cooperation, marking health literacy as a rather sensitive topic where parents do not want to be "educated" by teachers, questioning (rightly) the competence of teachers in this area. In addition, teachers themselves feel uncomfortable when they realise that they are expected to have a higher level of health literacy than they currently have. The study clearly highlights trust issues between parents and teachers, as well as confusion over responsibilities in health literacy.
Referencesde Buhr, E., & Tannen, A. (2020). Parental health literacy and health knowledge, behaviours and outcomes in children: a cross-sectional survey. BMC Public Health, 20, 1096.
Kickbusch, Ilona, Pelikan, Jürgen M, Apfel, Franklin & Tsouros, Agis D. (2013). Health literacy: the solid facts. World Health Organization. Regional Office for Europe. https://apps.who.int/iris/handle/10665/326432
Mikonnen, J., Remes, H., Moustgaard, H., & Martikainen, P. (2020). Evaluating the Role of Parental Education and Adolescent Health Problems in Educational Attainment. Demography, 57, 2245–2267. https://link.springer.com/article/10.1007/s13524-020-00919-y
Sanders, L. M., Federico, S., Klass, P., Abrams, M. A., & Dreyer, B. (2009). Literacy and child health A systematic review. Archives of Pediatrics and Adolescent Medicine, 163(2), 131-140. https://doi.org/10.1001/archpediatrics.2008.539.
Sørensen, K., Pelikan, J., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., Fullam, J., Kondilis, B., Agrafiotis, D., Uiyers, E., Falcon, M., Mensing, M., Tchamov, K., Broucke, S., & Brand, H. (2015). Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). The European Journal of Public Health, 25(6), 1053–1058. doi: 10.1093/eurpub/ckv043 https://pubmed.ncbi.nlm.nih.gov/25843827/
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