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Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study

BACKGROUND: Health education is particularly important for people with mental illness because they are at higher risk of becoming overweight or obese and developing type 2 diabetes than are members of the general population. However, little is known about how to provide health education activities t...

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Autores principales: Hempler, N. F., Pals, R. A. S., Pedersbæk, L., DeCosta, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208025/
https://www.ncbi.nlm.nih.gov/pubmed/30376824
http://dx.doi.org/10.1186/s12888-018-1924-3
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author Hempler, N. F.
Pals, R. A. S.
Pedersbæk, L.
DeCosta, P.
author_facet Hempler, N. F.
Pals, R. A. S.
Pedersbæk, L.
DeCosta, P.
author_sort Hempler, N. F.
collection PubMed
description BACKGROUND: Health education is particularly important for people with mental illness because they are at higher risk of becoming overweight or obese and developing type 2 diabetes than are members of the general population. However, little is known about how to provide health education activities that promote engagement and motivation among people with mental illness. METHODS: This study used ethnographic methods to examine barriers and facilitators of effective health education targeting people with mental illness by applying the concept of flow as a theoretical framework. Flow refers to immersion in an activity and is related to motivation. Data were collected through participant observation during eight health-educating activities and were thematically analysed using the concept of flow. Fieldwork was carried out between May and July 2015 in Denmark. RESULTS: Barriers to flow included: 1) information overload, particularly of biomedical rationales for behaviour change; 2) a one-size-fits-all approach that failed to address the needs and preferences of the target group; and 3) one-way communication allowing little time for reflection. Educators promoted a state of flow when they spoke less and acted outside of a traditional expert role, thus engaging participants in the activity. Flow was facilitated when educators were attentive and responsive to people with mental illness, and when they stimulated reflection about health and health behaviour through open-ended questions, communication tools and in small group exercises. CONCLUSIONS: This study suggests that more focus should be paid to training of educators in terms of skills to involve and engage people with mental illness in health education activities.
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spelling pubmed-62080252018-11-16 Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study Hempler, N. F. Pals, R. A. S. Pedersbæk, L. DeCosta, P. BMC Psychiatry Research Article BACKGROUND: Health education is particularly important for people with mental illness because they are at higher risk of becoming overweight or obese and developing type 2 diabetes than are members of the general population. However, little is known about how to provide health education activities that promote engagement and motivation among people with mental illness. METHODS: This study used ethnographic methods to examine barriers and facilitators of effective health education targeting people with mental illness by applying the concept of flow as a theoretical framework. Flow refers to immersion in an activity and is related to motivation. Data were collected through participant observation during eight health-educating activities and were thematically analysed using the concept of flow. Fieldwork was carried out between May and July 2015 in Denmark. RESULTS: Barriers to flow included: 1) information overload, particularly of biomedical rationales for behaviour change; 2) a one-size-fits-all approach that failed to address the needs and preferences of the target group; and 3) one-way communication allowing little time for reflection. Educators promoted a state of flow when they spoke less and acted outside of a traditional expert role, thus engaging participants in the activity. Flow was facilitated when educators were attentive and responsive to people with mental illness, and when they stimulated reflection about health and health behaviour through open-ended questions, communication tools and in small group exercises. CONCLUSIONS: This study suggests that more focus should be paid to training of educators in terms of skills to involve and engage people with mental illness in health education activities. BioMed Central 2018-10-30 /pmc/articles/PMC6208025/ /pubmed/30376824 http://dx.doi.org/10.1186/s12888-018-1924-3 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hempler, N. F.
Pals, R. A. S.
Pedersbæk, L.
DeCosta, P.
Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study
title Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study
title_full Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study
title_fullStr Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study
title_full_unstemmed Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study
title_short Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study
title_sort barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208025/
https://www.ncbi.nlm.nih.gov/pubmed/30376824
http://dx.doi.org/10.1186/s12888-018-1924-3
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