Education for health is a process in which all public health and medical care personnel are involved. People learn both formally (planned learning experiences) and informally (unplanned learning experiences). Since the patient, the client, the consummer and the community expect public health and medical care personnel to assist them with health and disease issues and problems, the response of the professional "educates" the customer whether the professional intends to educate or not. Therefore, it is incumbent on all public health and medical care professionals to understand their educational functions and their role in health education. It is also important that the role of the specialist in education be clear. The specialist, as to all other specialists, has an in-depth knowledge of his area of expertise, i.e., the teaching/learning process; s/he may function as a consultant to others to enhance the educational potential of their role or s/he may work with a team or with communities or groups of patients. Specific competencies and knowledge are required of the health education specialist; and there is a body of learning and social change theory which provides a frame of reference for planning, implementing and evaluating educational programs. Working with others to enhance their potential to learn and to make informed decisions about health/disease issues is the hallmark of the health education specialist.

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The failure to plan the health education component of a health service program together with the total planning effort has severely limited the contribution education could make to program goals. This case study illustrates the use of the systematic observation of behavior to identify factors which facilitated or hindered the development of a hypertension control program in ambulatory facilities and boards of health. The relationship of these factors to the planning process is discussed. Although this project deals with hypertension, the factors identified as facilitating or hindering change are applicable to any public health program.

The primary responsibility of the health education specialists working in the community is to help individuals, groups, or communities to make informed decisions about issues related to personal, community, or societal health. The educator carries out this responsibility through planned educational programs (planned learning experiences) in which the learner(s) is directly involved. These experiences can be short-term or long-term, and the involvement of the learner can take many forms. Learning/change may be experienced through group discussion, a variety of printed and/or audio-visual materials, formal classes, observation of others, community activities, field trips, participation in a study, or a number of other methods. Learning/change usually occurs over time as a result of a number of different learning experiences. One method rarely results in learning/changing.' I Health education specialists employ an orderly, defined process in carrying out their responsibilities. Working with the target population, the health education specialist assists in defining needs, developing goals and objectives, planning educational programs, coordinating and implementing the planned program and evaluating the program in terms of its goals and objectives. Sometimes this process is defined in today's literature as &dquo;marketing.&dquo;In the real world of practice, the health educator is not always able to follow the process step by step. Sometimes administrators want to initiate program, and neither time nor resources are available to do an adequate needs assessment, so a program is launched without one. Knowing this, however, the educator can gather data from the program and other sources to get a sense of the needs of the target population. Other steps in the planning process are sometimes aborted because of political realities. Again, the educator, aware of this, adjusts the program accordingly. The key issue is that the educator understands the process and compensates when possible for barriers that often occur in implementing it.Hcalth education specialists should convey to their administration that there is an orderly process by which educational programs are planned, implemented, and evaluated and should identify barriers that prevent this process from being effectively developed. Seven responsibilities and related functions, skills, and knowledge essential to program development have been defined by the Role Delineation Project2 for the generic entry-level health educator. Three of the seven responsibilities, communication, coordination, and serving as a resource for health education, are integral to the process of developing educational programs. The remaining four responsibilities, determining need, planning, implementing, and evaluating, are the essential steps in the process. Finally, there is a body of theory and there are principles of learning/social change that offer a frame of reference for planning educational programs. These theories and principles provide the assumptions that explain and predict human be...