Health Education And Current Challenges For Family Essay

Health Education And Current Challenges For Family Essay

Health Education And Current Challenges For Family Essay

Explain the role of health education in health promotion. How is the nursing process used in developing health education? Describe a contemporary issue, local or global, that a family may experience today. What steps would the nurse take to address these as part of a health education plan?Health Education And Current Challenges For Family Essay

Although a universally accepted definition of the term ”school health services” has not been adopted, the School Health Policies and Programs Study (SHPPS) has described school health services as a “coordinated system that ensures a continuum of care from school to home to community health care provider and back” (Small et al., 1995). The goals and program elements of school health services vary at the state, community, school district, and individual school levels. Some of the factors that contribute to these variations include student needs, community resources for health care, available funding, local preference, leadership for providers of school health services, and the view of health services held by school administrators and other key decisionmakers in the school systems.Health Education And Current Challenges For Family Essay

There is similarity, however, in the types of services offered from one school system to the next, which is likely the result of several factors. A majority of states have state school nurse consultants, many of whom have distributed sample policy and procedure manuals from their state department of health or education or both, to guide the development and delivery of health services in local settings. The National Association of School Nurses has defined roles and standards for school nurses (Proctor et al., 1993) and provides a system for disseminating information and

Permalink:…for-family-essay/ ‎

Page 154
Suggested Citation:”4 School Health Services.” Institute of Medicine. 1997. Schools and Health: Our Nation’s Investment. Washington, DC: The National Academies Press. doi: 10.17226/5153.×
Add a note to your bookmark
training to nurses who practice in schools. The American School Food Service Association has recently released standards for school foodservice and nutrition practices (American School Food Service Association, 1995). Similarly, organizations such as the National Association of School Psychologists, the American School Counselor Association, and the National Association of Social Workers have published position statements and standards for their professions. The American School Health Association (ASHA), through its interdisciplinary committees, has studied the advantages and disadvantages of different services, the organization and delivery of services, and the roles of various school health service providers. Subsequently, ASHA publications have brought this information to the attention of state and local health and education agencies. The American Academy of Pediatrics, working closely with national representatives of the school health services sector as well as the community health system, periodically updates a school health manual, School Health: Policy and Practice , that serves both as another unifying force and as an informal mechanism for ensuring local program quality (American Academy of Pediatrics, 1993). Within this document are the following seven goals of a school health program:Health Education And Current Challenges For Family Essay

Goal 1

Ensure access to primary health care.1

Goal 2

Provide a system for dealing with crisis medical situations.

Goal 3

Provide mandated screening and immunization monitoring.

Goal 4

Provide systems for identification and solution of students’ health and educational problems.

Goal 5

Provide comprehensive and appropriate health education.

Goal 6

Provide a healthful and safe school environment that facilitates learning.


It should be noted that the IOM (IOM) Committee on the Future of Primary Care has distinguished between the terms “primary care” and “primary health care” (Institute of Medicine, 1994). According to its definition, “primary care” refers to personal health ser

Medicine. 1997. Schools and Health: Our Nation’s Investment. Washington, DC: The National Academies Press. doi: 10.17226/5153.×
Add a note to your bookmark
TABLE 4-1 Health Services Provided in the Schools

Type of Service

Percentage of Districts Providing Service

Administer first aid


Administer medication


Provide screening (height/weight) vision, hearing


Child abuse evaluation and follow-up


Evaluate emotional or behavioral problems


Monitor vital signs


Clean and change dressings


Health component of Individualized Education Plan (IEP)Health Education And Current Challenges For Family Essay


Case management for chronic health problems


Provide nutritional counseling


Provide mental health counseling


Conduct cardiovascular screenings


Provide complex nursing care to students with special needs


Employee wellness programs


Physical fitness screenings


Perform urinary catheterizations


Conduct health risk appraisals to determine life-style practices


Process worker’s compensation claims


Provide immunizations at school


Physical exams


Provide family counseling


Tube feedings




Perform dental services


Conduct alcohol and drug screenings


Health component of Individualized Family Service Plan (IFSP)


Administer or monitor oxygen


Provide alcohol and drug treatment


Provide physicals, other primary health care services for school employees


Provide prenatal care


Collect and test blood samples


Throat cultures


Provide prenatal testing




SOURCE: From Davis et al., 1995.

Page 157
Suggested Citation:”4 School Health Services.” Institute of Medicine. 1997. Schools and Health: Our Nation’s Investment. Washington, DC: The National Academies Press. doi: 10.17226/5153.×
Add a note to your bookmark
duct health risk appraisal to determine life-style practices. The committee has not attempted to reconcile these figures with those reported by SHPPS, which states that 89.2 percent of senior high schools and 84.4 percent of middle or junior high schools provide individual counseling. The latter figures could refer to counseling with primarily an academic focus, which schools may be more inclined to offer, although there is certainly overlap between academic and mental health problems. Data from A Closer Look indicate that the types of services available to students do not appear to vary substantially by the size of the school district.Health Education And Current Challenges For Family Essay

The Need for School Health Services
Since schools bring large numbers of students and staff together, prudence dictates that—as in any workplace—a system must be in place to deal with such issues as first aid, medical emergencies, and detection of contagious conditions that could spread a group situation. Unlike other workplaces, however, a system must also be established in schools to provide routine administration of medications, since students—especially young students—may not be able to assume this responsibility themselves, and concern for substance abuse has led to policies in most schools that prohibit older students from administrating their own medication. Laws pertaining to special education students2 require that schools provide the services necessary for these students to receive an appropriate education. Such services might include monitoring vital signs, changing dressings, catheterization, tube feeding, or administering oxygen. The school must also provide services to non-special education students with chronic health problems—such as asthma, diabetes, and seizures—in order that they can be educated. Schools have little or no choice in providing such services, for they are dictated either by legislative mandate or by precautions pertaining to risks and liability.

Services such as screenings and immunizations are also widely accepted as belonging in the schools, with the motivation having to do more with access, efficiency, and economies of scale than with liability. Since schools are where children spend a significant portion of their time, schools are seen by many observers as the logical site for services that are based on public health principles of population-based prevention. There is some debate, however, about the relative benefits and disadvantages of a population-based versus a selective high-risk approach, which targets Health Education And Current Challenges For Family Essay


“Special education” students are those with a wide range of disabilities, including mental retardation; hearing, visual, and speech impairment; serious emotional disturbances; orthopedic impairments; and learning disabilities (Walker, 1992).

Page 158
Suggested Citation:”4 School Health Services.” Institute of Medicine. 1997. Schools and Health: Our Nation’s Investment. Washington, DC: The National Academies Press. doi: 10.17226/5153.×
Add a note to your bookmark
preventive services only toward children at high risk. The population-based approach has the advantage of producing a large potential impact on the population as a whole, but a major disadvantage is that the benefits are frequently very small for the individual. Another potential disadvantage is that all interventions have a finite risk of unintended adverse side effects, which are also amplified along with benefits in the population-based approach, possibly resulting in an unfavorable benefit-risk ratio. Depending on the health issue, one approach may be superior to the other, or a combination of the two may be appropriate. For example, the National Cholesterol Education program recommends a population-based approach for implementing dietary guidelines for children, combined with a high-risk approach to blood lipid screening targeted only at children considered at risk based on family history (Starfield and Vivier, 1995).

Further, schools are strategically positioned to serve in the public health battle against the resurgence of infectious diseases, such as tuberculosis and hepatitis. Another feature of school health services—one that is often overlooked—is its potential for expanding the knowledge base. School health services can be a rich source of data for studying the relation between health status and learning capacity, and for assessing unmet needs and monitoring the health status of children and adolescents.Health Education And Current Challenges For Family Essay

Given the above needs and benefits, a basic health services program must be in place in all schools. The issues currently generating much discussion and debate, however, are the role of the school in providing access to primary care, the appropriate lead agency for the more traditional basic school health services, the advantages and disadvantages of a population-focused versus a high-risk approach to the delivery of health services in schools, and the need to develop an integrated system of school health services.

The role of the school in providing access to primary care is a particularly difficult and critical issue. Since schools are a public system whereas health care is predominately private, there appears to be a fundamental mismatch between the two systems. Many students already have their own source of primary care, but a significant and growing segment of the student population does not. Those students without access to primary care are usually poor and are often at greatest risk of academic failure.

Special Needs Due to Poverty
Chapter 1 of this report documents some of the major problems facing children and adolescents in this country—the new social morbidities, changing family structures, limited access to health care, and lack of health Health Education And Current Challenges For Family Essay

Page 159
Suggested Citation:”4 School Health Services.” Institute of Medicine. 1997. Schools and Health: Our Nation’s Investment. Washington, DC: The National Academies Press. doi: 10.17226/5153.×
Add a note to your bookmark
TABLE 4-2 Relative Frequency of Health Problems in Low-Income Children Compared with Other Children

Health Problem

Relative Frequency in Low-Income Children

Low birthweight


Delayed immunization




Bacterial meningitis


Rheumatic fever


Lead poisoning


Neonatal mortality

1.5 times

Postneonatal mortality


Child deaths due to accidents


Child deaths due to disease


Complications of appendicitis


Diabetic ketoacidosis


Complications of bacterial meningitis


Percentage with conditions limiting school activity


Lost school days

40 percent more Health Education And Current Challenges For Family Essay

Severely impaired vision


Severe iron-deficiency anemia


SOURCE: Starfield, 1982, 1992.

insurance. Poverty is the common denominator among many of these problems.

Research has identified an explicable link between poverty and health outcomes. Children in poverty are much less likely than their affluent peers to receive an excellent or very good health rating, and they visit their health care provider fewer times in a year. Low-income families, facing routine pediatric care costs that consume a large fraction of their annual income, may decide they cannot afford health care until their children’s treatment leads to unnecessary hospitalization and valuable days lost from school (see Table 4-2). For example, preventable hospitalizations for pneumonia, asthma, and ear, nose, and throat infections are up to four times higher for poor children than for who are not poor children (Center for Health Economics Research, 1993). Poor children are also more likely to be limited in school or play activities by chronic health problems and to suffer more severe consequences than their more affluent peers when afflicted by the same illness (Newacheck et al., 1995).Health Education And Current Challenges For Family Essay

Page 160
Suggested Citation:”4 School Health Services.” Institute of Medicine. 1997. Schools and Health: Our Nation’s Investment. Washington, DC: The National Academies Press. doi: 10.17226/5153.×
Add a note to your bookmark
Relative Frequency of Health Problems in Low-Income Children Compared with Other Children
It is estimated that as many as 12 million children under the age of 18 have no health insurance, or approximately 17 percent of all children in that population (American Medical Association Council on Scientific Affairs, 1990). Millions more have inadequate plans that fail to cover even basic preventive services, such as immunizations (National Health Education Consortium, 1992). Although progress has been made in establishing publicly financed community health centers in inner cities and rural areas, school-age youth rarely visit these facilities until their health problems reach crisis stage. Although Medicaid is intended to provide services for poor children, variations in state Medicaid policies have left almost 40 percent of children who live in poverty without access to basic primary and preventive care (Solloway and Budetti, 1995). Possible changes in the system imply even greater uncertainty about the role Medicaid will play in providing universal coverage for poor children and adolescents (Newacheck et al., 1995).Health Education And Current Challenges For Family Essay

Absenteeism among students is clearly associated with school failure (Wolfe, 1985). Research has shown that students who miss more than 10 days of school in a 90-day semester have trouble remaining at their grade level (Klerman, 1988). In particular, children who are poor are two to three times more likely to miss school due to their illnesses (Starfield, 1982). Indeed, children with health problems are disproportionately poor students on the verge of academic failure. Youth frequently must miss valuable class time in order to get care for their illnesses during the regular office hours of public and private health professionals. In fact, a recent study found that students utilizing public clinics missed entire days of school per appointment (Kornguth, 1990). Thus, “health-related risk factors often set in motion a cycle of absenteeism and school failure” (Lewis and Lewis, 1990). Studies have also found that people living in poverty are twice as likely to have mental health problems; hence, low-income children are especially affected by the absence of accessible mental health care (Starfield, 1982).

Given these findings, it appears that the lack of accessible primary care has a high cost, in terms of both health and education outcomes. Providing primary care to needy students at the school site has been proposed to be efficient and cost-effective in the long run, in order to improve academic performance and detect health problems early before they require more expensive treatment. Then the difficult question naturally follows: Would all students, not only those in poverty, benefit from availability of convenient, accessible basic primary care services at school, provided by professionals specially trained to deal with their age level? Health Education And Current Challenges For Family Essay

Page 161
Suggested Citation:”4 School Health Services.” Institute of Medicine. 1997. Schools and Health: Our Nation’s Investment. Washington, DC: The National Academies Press. doi: 10.17226/5153.×
Add a note to your bookmark
their studies of school-based health centers (SBHCs) in northern California, Brindis and coworkers found that a higher proportion of students who already had conventional private insurance or health maintenance organization (HMO) coverage utilized the SBHC than those without other coverage, suggesting that ease of access and an understanding staff are perhaps more important factors in utilization than the mere lack of other source of care (Brindis et al., 1995). (The surprisingly greater rate of utilization for students who already have insurance may possibly be attributed to their greater awareness of the importance of health care, parental encouragement, or understanding how to access the system.) Also, many working parents apparently appreciate the convenience of their children being able to receive basic health care at school (U.S. General Accounting Office, 1994b). If the school is seen as the most effective site for providing a set of basic primary services, how can these services be organized? Who will pay? How will these services be connected with the traditional “core” services of the school? These are questions without easy answers—or possibly, with different answers depending on the community. Some of these issues are considered in greater depth later in this chapter.Health Education And Current Challenges For Family Essay

The following section provides a summary of typical services found in the school setting. These services tend to be the most common and basic, although many schools may not provide all of the services described in this section. For the sake of organization, services have been divided into three categories: health care services, mental health or pupil services, and nutrition and foodservice. It should be emphasized that boundaries between categories are not sharp, and considerable overlap and interaction among services exist.

For each category, there is a description of the service, information about the personnel who provide the service, and a review of some of the important issues in that field. Much of the material in this section came from the discussion at the committee’s third meeting and was contributed by representatives of various professional organizations who served on a panel on services at that meeting. The committee has not attempted to assess the professional standards, recommended student-professional ratios, or other issues in this section for validity or adequacy; instead, this section is intended simply to transmit the contributed information. For further details, the professional organizations can be contacted directly.Health Education And Current Challenges For Family Essay


Participants in the panel discussion on services at the committee’s third meeting included representatives from the National Association of School Nurses, American Academy of Pediatrics, National Association of School Psychologists, American School Counselor Association, National Association of Social Workers, and American School Food Service Association.

Page 162
Suggested Citation:”4 School Health Services.” Institute of Medicine. 1997. Schools and Health: Our Nation’s Investment. Washington, DC: The National Academies Press. doi: 10.17226/5153.×
Add a note to your bookmark
Additional information may also be obtained from the University of Colorado School Health Resource Services project, which maintains an extensive reference collection of profiles of school health services programs from school districts throughout the country.Health Education And Current Challenges For Family Essay

Health Care Services
Nurses and Nurse Practitioners
Services Provided. School nurses are the traditional “backbone” of school health services and are often the only health care providers at the school site on a regular basis. As mentioned earlier in this chapter, standards for school nursing have been established by the National Association of School Nurses. The school nurse typically provides population-based primary prevention and health care services, including

physical and mental health assessment and referral for care;

development and implementation of health care plans for students with special health care needs;

health counseling;

mandated screenings, such as vision, hearing, and immunization status;

monitoring the presence of infectious conditions among students and enforcing public health precautions to prevent spread of infections and infestations;

skilled nursing services for students with complex health care needs;

case management of students with chronic and special health care needs;Health Education And Current Challenges For Family Essay

outreach to students and their families;

interpretation of the health care needs of students to school personnel;

development and implementation of emergency care plans and provision of emergency care and first aid;

serving as liaison for the school, parents, and community health agencies

collaboration with other school professionals—particularly counselors, psychologists, and social workers—to address the health, developmental, and educational needs of students; and

Page 163
Suggested Citation:”4 School Health Services.” Institute of Medicine. 1997. Schools and Health: Our Nation’s Investment. Washington, DC: The National Academies Press. doi: 10.17226/5153.×
Add a note to your bookmark
for nurse practitioners only, the provision of primary care, including prescribing medications when allowed under the State Nurse Practice Act.

The traditional model for school nursing provides for a school nurse, typically in an office or health room, with or without an aide. The National Association of School Nurses and other organizations in the National Nursing Coalition for School Health have prepared and distributed standards of nursing practice that guide the services nurses deliver in schools (Proctor et al., 1993). A single nurse may also be shared among several schools. In School Health: Policy and Practice, the American Academy of Pediatrics has analyzed the various nurse staffing patterns which are listed in Table 4-3.Health Education And Current Challenges For Family Essay

Personnel. The professional training required for school nurses varies, depending on location and changing economic conditions. The American Academy of Pediatrics (1993) reported in 1993 that only 38 states required school nurses to be registered nurses, and only 19 required the attainment of specific school nurse certification. SHPPS found that although only 8 percent of all states required school nurses to be certified through the American Nurses Association or the National Association of School Nurses, 62 percent of states offered their own certification for school nurses. Of those states offering certification, 66 percent required it for employment as a school nurse. Health aides are employed in 76 percent of states, but only 8 percent of these states required prior technical training for health aides (Small et al., 1995). The Closer Look investigation reports similar findings.

In some school districts, school nurses are employees of the school system; in others, school nurses are provided by the local health department or another agency. The National Association of School Nurses recommends a ratio of one school nurse per 750 students. In recent years, there has been interest in expanding the school nursing function through the use of nurse practitioners, nurses with additional training (generally at the master’s level) who are certified by state laws to provide a range of primary care services. School-based nurse practitioners can perform physical examinations, prescribe certain medications with physician protocols, and frequently serve as the anchor provider in school-based clinics. The drive for independence from physicians has characterized the nurse practitioner movement (Clawson and Osterweis, 1993); however, school-based nurse practitioners usually have a backup relationship with a licensed physician in the community. Other graduate programs prepare school nurses for administrative and management roles, as well as for mental health positions in schools.Health Education And Current Challenges For Family Essay

The following definition of health promotion is from the World Health Organization’s Ottawa Charter for Health Promotion [71]:

The process of enabling people to increase control over and improve their health.It involves the population as a whole in the context of their everyday lives, rather than focusing on people at risk for specific diseases, and is directed toward action on the determinants or causes of health.

Universal child and family health services have the opportunity to conduct a range of evidence-based health promotion strategies that aim to encourage families to create attitudes, behaviours and environments to promote optimal health for children.

There are many ways in which health promotion is delivered in a universal child and family health service and these may include:

the provision of information to parents through written or audio-visual resources;
a discussion between the worker and the family, or demonstration of a health- promoting behaviour;
role modelling through specifically set up groups and through experiences of other parents; and
community awareness activities.
There are four core service elements related to health promotion:
1. prevention of disease, injury and illness;Health Education And Current Challenges For Family Essay
2. health education, anticipatory guidance and parenting skill development;
3. support that builds confidence and is reassuring for mothers, fathers and carers; and
4. community capacity building.
Prevention of disease, injury and illness
Prevention of disease is a core component of child and family health service provision. The combination of monitoring of child and family health whilst conducting preventative health activities provides opportunities for early intervention and detection and the prevention of ill-health. Disease-prevention activities include: immunisation, promotion of breastfeeding and nutrition, information about SIDS and co-sleeping, oral health surveillance, and safety and injury prevention, for example, road safety.

Examples of effective health promotion activities for child and family health
Promoting breastfeeding
Promoting child and family nutrition
SIDS prevention and education [72]
Injury prevention [73]
Promoting physical activity
Smoking cessation programs such as ‘quit’ activities and ‘brief interventions’
Promoting early literacy [63, 73]
Health education, anticipatory guidance and parenting skill development
Health education, anticipatory guidance and parenting skill development are interrelated components of health promotion. These components may occur during individual contact with parents and carers, or in a group setting [74, 75]. The benefits of a group delivery include peer support and cost-effective use of resources.

The World Health Organization (1998) defines health education as ‘consciously constructed opportunities for learning, involving some form of communication designed to improve health literacy, including improving knowledge, and developing life skills which are conductive to individual and community health’.Health Education And Current Challenges For Family Essay

Health education is not only concerned with the communication of information, but also with fostering the motivation, skills and confidence (self-efficacy) necessary to take action to improve health.

For example, health education by child and family health services includes providing structured breastfeeding support. Systematic reviews in the Cochrane Library have identified the importance of support to the success of breastfeeding [76] with both peer and professional support shown to be effective in increasing breastfeeding rates during the first two months following birth. Child and family health nurses are regularly involved in interventions providing structured breastfeeding support to mothers [77].

Universal child and family health services provide structured anticipatory guidance about a child’s development and behaviour. Anticipatory guidance gives parents practical information about ‘what to expect’ in the child’s behaviour, growth and development in the immediate and longer term. It provides parents with the knowledge they need to provide positive experiences and environments for their child and reduces the anxiety for new parents. For example, universal child and family health services are well positioned to actively influence parents and carers to undertake activities that promote literacy development [67].Health Education And Current Challenges For Family Essay

Furthermore, through play, children practise and master the necessary skills needed for later childhood and adult life [78]. Parents and carers play an important role in the facilitation of play as they respond to and promote the interactions of their child. Child and family health services can promote play as the ‘work’ of infants and young children and necessary for the development of language, symbolic thinking, problem solving, social skills, and motor skills.

Anticipatory guidance may also be provided for the mother’s health and wellbeing. Common anticipatory guidance topics based on the review of state and territory frameworks are provided in Table 6.
Top of page
Health education and anticipatory guidance topics
physical needs of the infant/young child information and skills development – feeding, bathing, clothing, skin care
normal infant and child sleep expectations and settling management
nutrition – breastfeeding, introducing a healthy diet, weaning
oral health education [79]Health Education And Current Challenges For Family Essay
emotional needs of the infant – mother/child interaction, attachment, early brain development
normal behaviour and behaviour management – tantrums, self-comforting behaviour, separation anxiety, toilet training
activities to support development – speech and language, early introduction to books, movement and activity [73, 80]
developmentally appropriate play activities
child safety
preparing for preschool and school
Parent recall of health promotion and anticipatory guidance decreases with increasing numbers of topics set for each discussion. One study found that when more than nine topics were discussed at any one session, parent recall decreased significantly [81]. Services may determine health promotion education strategies beyond the core health promotion topics above to reflect the needs of the community, or their practice wisdom. However, some targeting of messages at each contact is likely to improve the effectiveness of the activities. It is important that clinicians develop the skill of recognising ‘teachable moments’ [82], or times when parents are keyed into an issue and express interest and are therefore receptive to input.

Support for mothers, fathers and carers
Parents value appropriate support to assist in building confidence across key transition points such as transition to parenthood [83] and transition to school [84].

Maternal health
The health of the mother (or primary carer) is integral to the health and wellbeing of the child and family. Many women report feeling unprepared for the transition to motherhood [85-87], lack confidence in their parenting skills and there is a high occurrence of parental stress, postnatal distress and depression in the short and long term after birth [27, 88, 89]. Physical recovery from birth may take 9-12 months and women report health problems including bowel problems, urinary incontinence, perineal pain, backache and exhaustion [90-92]. Some women also experience difficulties with breastfeeding in the early postnatal period, such as pain and nipple damage, inadequate milk supply and mastitis.Health Education And Current Challenges For Family Essay

These health problems affect the quality of a woman’s life and may impact on her relationships [92]. The universal child and family health service is ideally situated to identify any physical health issues and offer appropriate advice and referral for women.

Perinatal mental health problems are known to impact significantly on the woman [24, 93], her infant and family [88]. The relationship between an infant and their primary caregiver is significantly affected by maternal depression and can negatively influence the child’s long-term mental and physical health [94]. Periodic contact with child and family health services provides an important opportunity to ask a mother, father and/or other primary carers about their own social and emotional wellbeing and to identify risk for and/or detect possible depression or related disorders. Services can then offer support and appropriate early intervention or referral [4]. The (draft) Clinical Practice Guidelines [95] recommend the Edinburgh Postnatal Depression Scale (EPDS) be used by health professionals as an initial step in screening all omen for possible depression in the ante and postnatal period.Health Education And Current Challenges For Family Essay

Engaging fathers
Child and family health services can further promote the wellbeing of children by harnessing the full potential of fathers to contribute to the wellbeing of children and families.

‘Father-inclusive’ practice occurs when the needs and perspectives of fathers are incorporated into the planning, development and delivery of services. For services aiming to support families, bringing fathers into everyday activities is a crucial part of inclusive practice.

One example of a national parenting initiative for fathers is the Strong Fathers, Strong Families program for Aboriginal and Torres Strait Islander men. This program is providing antenatal programs specifically for males to support them in preparing for fatherhood; community and group activities and strategies that promote positive, healthy, active fatherhood and grandfatherhood, and the involvement of males in the early development of their children and grandchildren; health promotion information that promotes new fatherhood and grandfatherhood as a motivating factor for self care; and referral and support to attend local parenting, health and related services (e.g. reproductive health, family wellbeing, counselling, peer support groups) as needed.Health Education And Current Challenges For Family Essay

Table 7: Principles of Father-Inclusive Practice [96]
Principle 1. Father Awareness: Services develop an understanding of the role and impact of fathers including separated fathers, father figures and stepfathers
Principle 2. Respect for Fathers: Services engage with fathers as partners with respect for their experience, gifts and capacities as fathers.
Principle 3. Equity and Access: All fathers have equal and fair access to the support provided by high quality family services regardless of income, employment status, special educational needs or ethnic / language background.
Principle 4. Father Strengths: A strengths-based approach recognises fathers’ aspirations for their children’s wellbeing and the experience, knowledge and skills that they contribute to this wellbeing.
Principle 5. Practitioners’ Strengths: The existing skills, knowledge and special qualities of the staff for working with fathers are acknowledged.
Principle 6. Advocacy and Empowerment: Services aim to empower fathers to develop their capacity rather than focus on interventions that try to prevent them from doing harm.
Principle 7. Partnership with fathers: Services aim to work in partnership with fathers and their families to build on their knowledge, skills and abilities and to help fathers enhance their positive roles with their children and as part of families.
Principle 8. Recruitment and Training: Appropriate training, credentialling and professional support for staff is a foundation for quality father-inclusive service provision.Health Education And Current Challenges For Family Essay
Principle 9. Research and Evaluation: Research and evaluation of services should specifically measure father engagement and outcomes relating to this engagement.

Facilitating peer support
Child and family health services provide support for mothers, fathers and carers across key transition points in the early childhood period. For example, CFHNs may facilitate both ‘preparations for parenthood’ and ‘new parents’ groups to address their needs during this transition period. Research suggests increased levels of social support and parenting confidence and high levels of satisfaction amongst parents who attend new parents’ groups facilitated by CFHNs [97-99]. Facilitated peer support groups appear to be successful in
de-emphasising the power and expertise of the professional [99]. These groups often become self-sustaining social networks providing important support for parents [98].

Community capacity building
Community capacity building is an essential health promotion activity crucial to the achievement of the objectives of the Framework. Capacity building has been broadly defined as encompassing:
empowerment of individuals and groups within defined ‘communities’;
development of skills, knowledge, and confidence;
increased social connections and relationships;
responsive service delivery and policy based in community-identified needsand solutions;Health Education And Current Challenges For Family Essay
audible community voices;
community involvement;
responsive and accountable decision makers;
resource mobilisation for communities in need; and
community acceptance of programs because they have been involved in development [100].
Capacity building for health promotion can occur with individuals, groups, organisations and communities and includes three core aspects: adequate infrastructure and resources in order to build capacity in individuals and communities, the establishment and maintenance of partnerships and networks are key to ensuring developed programs are sustainable and finally, organisations and communities must develop a ‘problem solving’ approach to health improvement strategies [100]. Universal child and family health services play a key role in community capacity building via activities such as community workshops, health promotion and education activities, collaboration between government and non-government organisations and community agencies such as the Australian Breastfeeding Association and early education and care Education And Current Challenges For Family Essay