1 CRITERIA AND GUIDELINES FOR ACCREDITING GRADUATE PROGRAMS IN COMMUNITY HEALTH EDUCATION COMMITTEE ON PROFESSIONAL EDUCATION THE APHA has accepted responsibility Tfor accrediting master's level programs in community health education, not only in schools of public health but also in other institutions that offer such graduate programs. As an aid in assessing these programs, the following statement of criteria and guidelines has been developed and approved by the Committee on Professional Education. Accreditation serves several purposes. It stimulates a desire for improvement of professional programs of preparation within an institution, often beyond the minimum accreditation standards. Its objectives must serve the public interest, and identify those educational institutions and programs that are adequate for the demands of the times and the needs of the public in the future. Accreditation should not, however, have the effect of restricting education into conformity and subsequent obsolescence. Dr. William Selden said: "Accreditation, improperly conducted, could support professional conservatism, rigidity, and selfishness. It could prevent the introduction of new methods, and it could, indirectly, place limits on enrollments. In contrast, accreditation, properly conducted, can and does provide, even with all its limitations and inadequacies, a protection for the public and an assurance to the profession. It can and does indicate, sometimes after too much of a social lag, the proper direction for the education of the future members of the profession." Accreditation in the specialized area of community health education gives some assurance that graduates of such programs will provide effective educational leadership in helping to resolve community health problems and issues that confront society. Education for behavioral change is basic to the effectiveness of community health action, and the quality of preparation for educational leadership in large measure determines the attainment of such action. In effect, the interpretation and appropriate utilization of community health services to a large extent are dependent upon leadership exerted by qualified community health educators. This leadership is achieved best when generally accepted standards serve as criteria for accrediting educational programs designed to produce qualified community health educators. Therefore, these criteria and guidelines have been developed to assist in promoting that level and quality of education essential for the provision of highly qualified community health educators who are capable of assuming leadership in community health and education programs. 1. PROGRAM MISSION, FACULTY, AND INTERRELATIONSHIPS A. Definition of the Program Mission, Functions, and Purposes The department, or program area faculty, should define educa- S34 VOL. 59, NO. 3. A.J.P.H.
2 GRADUATE PROGRAMS IN COMMUNITY HEALTH EDUCATION tional purposes for each program offered. Included should be, for each program offered, a statement of objectives which represents the consensus of the faculty. The faculty should identify and describe its approach to the major areas of knowledge and professional activity relevant to the preparation of community health educators. It is important to consider the relationship of the department's or program area's mission, functions, and purposes to those in other institutions of the same general type. Creativity should be encouraged, and special or uncommon objectives, areas of knowledge, and program activity should be identified and explained. It should be indicated when and by whom these statements were prepared, where they are published, and how they are used in institutional planning. If no official statement exists, an appropriate description of the department or special program area should be prepared. Emphases may differ from one department or program area to another; but in carrying out its individual, selfdetermined mission, each department or program area defining as its mission the preparation of community health educators will gear its program to the following purposes: 1. To provide the broad professional education appropriate for each degree offered and required by community health leaders who need: (a) the essential knowledge basic to the field of community health education found in the biologic, physical, and social sciences; and (b) the mastery of skills and educational methodology necessary to apply scientific and technical knowledge in the changing economic and political contexts of modem society. 2. To prepare community health educators who will work in community agencies to: (a) analyze situations in terms of educational needs; (b) plan the educational aspects of programs so as to utilize the contributions of other health and related specialists; (c) assist other health and related specialists in applying educational principles and concepts; (d) assume major responsibility for seeing that educational activities are carried out and coordinated, and that a sound plan for evaluating the educational component of the program is incorporated B. Stature and Number of Faculty 1. (a) The faculty member with immediate responsibility for developing and monitoring the curriculum for community health education specialists should be full-time, with educational qualifications and professional experience in both public health and community health education. This should include attainment of the M.P.H., M.S.P.H., or equivalent degree such as M.S. in H.Ed. In addition, an earned doctoral degree, with emphasis in health education or in an area directly relevant to health education, is considered important. (b) The faculty teaching the basic public health sciences part of the curriculum should have qualifications that conform with those specified in the standards prepared by the Committee on Professional Education of the APHA for accreditation of schools of public health. (c) The faculty in the health complex, and in other university areas with disciplines basic to public health and community health education, should be viewed as instructional resources to be utilized in this program whenever appropriate. (d) Those responsible for developing the instructional program should devise ways and means of arranging courses and faculty schedules, so as to optimize inter- MARCH,
3 actions between faculty and students and between the different faculty disciplines in order to obviate the disadvantages of utilizing parttime faculty members. (e) Other members of the faculty who teach community health education eourses should have specific experience and academic qualifications in this special field. (f) The faculty should be large enough in relation to enrollments and programs to establish a facultystudent ratio recommended in and commensurate with acceptable standards for other graduate programs. 2. The department or program area should develop and maintain appropriate cooperative and joint relationships within the college or university, as well as with outside educational and service agencies. The department or program area will need to establish cooperative relationships within the college or university and with community services agencies so as to: (a) provide for maximum utilization of faculty resources outside the department or program area; (b) provide for development of effective working relationships with community educational institutions and service agencies, providing teaching and field experiences for students to supplement classroom teaching. II. ORGANIZATION AND ADMINISTRATION A. College or University Affiliation and Accreditation The department or program area responsible for preparation of community health educators must be an integral part of a college or university which is a member of one of the regional associations of colleges and universities. B. Organization and Operation Appropriate faculty in the department or program area should have responsibility for planning and conducting the program of study in community health education within the general frame of reference applicable to all programs in the college or university. C. Physical Facilities Appropriate and sufficient classrooms, laboratories, libraries, and other facilities should be available to carry out both the required and elective course work, including field experience. This means, for example, not only sufficient classrooms, seminar rooms, laboratories, and offices, but also accessible auditoria, libraries, reading and study rooms, data-processing equipment and services, and conveniently located administrative units of community health services available to faculty and students for observation, study, analysis, and criticism, and field experience of high quality. The availability and convenient access to adequate library facilities cannot be overemphasized as fundamental and necessary resources. D. Financing The department or program area should have an assured mini- 536 VOL. 59, NO. 3. A.J.P.H.
4 GRADUATE PROGRAMS IN COMMUNITY HEALTH EDUCATION mum basic budget adequate for its teaching, research, and service functions, and for meeting the various criteria and its own objectives. A program in community health education will require that faculty resources from related health and other academic sciences be maintained on a continuing basis. Selective relationships will need to be established with operating health, education, and social welfare agencies. Adequate financing is essential to make available these resources as an integral part of the program. III. EDUCATIONAL PROGRAM A. Degree Structure The department or program area should describe the broad content areas of each degree program for which its faculty is responsible, and which will comply with the degree standards and requirements of its college or university and graduate school. All colleges and universities interested in community health education need not have both undergraduate and graduate programs in community health education. The graduate degree offered must be appropriate for the educational institution in which the degree is offered. General requirements for the degree should be described carefully: how and by whom degree requirements are established; whether they include residence as well as course requirements, and other additions such as independent study and comprehensive examinations; whether they are uniform for all students; how exceptions are made, and whether there are any special requirements. General courses required of all students should be described, including how they are planned and taught; electives should be described as well as the procedures for choosing them. Arrangements for academic advising to meet degree requirements are important. The quality of an institution may be enhanced through the addition of graduate programs. On the other hand, diffusion of resources may actually diminish institutional effectiveness. Both general and departmental requirements for admission to the graduate division and for graduate degrees should be described. Criteria for courses carrying graduate credit and requirements for teaching in the graduate division should be established. B. Curriculum The department or program area should have curricula differentiated for the various degree programs offered. Each curriculum should be designed to provide the student with an opportunity to gain knowledge and skills and to establish a professional philosophy appropriate for his area of specialization. Curricula should include basic or general education requirements as well as professional components. Some of the knowledge, concepts, and skills fundamental to preparation for a specialty in community health education will have been provided in general education courses at the baccalaureate level. Foundation courses in the biological and social sciences and in education are especially important. Areas more specifically related to public health and health education, including field experience, may also have been covered in specially designed courses at the baccalaureate level under the guid- MARCH,
5 ance of faculty qualified in public health and community health education. Areas of knowledge, concepts, and skills required for the master's degree include some offered at the baccalaureate level, but such areas should be considered in greater depth and breadth at the master's level. Additional areas of study include research and theory underlying health education practice. Emphasis is placed on development of analytical and creative abilities needed to determine the educational components of health programs, the factors and methods to be considered in achieving educational goals, and the ways of evaluating programs. The master's level of preparation should prepare the student to assume leadership responsibilities in supervision, consultation, and administration. If experience has not been a requirement at the bachelor's level, it should be included at the master's level. Well-defined, supervised field experiences should supplement theoretical instruction. C. Admission and Degree Requirements Each department or program area should enforce appropriate admission requirements that conform to the standards of its college or university, and that will insure the realization of its own stated mission, purposes, and objectives. a. Admission Requirements - Master's Degree Admission requirements to programs of study for the preparation of community health educators at the master's level include a bachelor's degree from an acceptable institution in addition to appropriate preparation in areas of knowledge, concepts, and skills pertaining to community health education, including preparation in selected biological and social sciences and in psychological and sociological foundations of education. b. Degree Requirements-Master's Degree The program should include courses concerned with an orientation of the student to community health concepts and practices in general, and an introduction to public health sciences in particular. In addition, a student should fulfill other requirements equivalent to those required of candidates for similar master's degree programs in other parts of the university. The fields of instruction to be attained or competence to be demonstrated at the master's degree level for community health educators before the degree is awarded are related to the following objectives. (1) To provide the community health education specialist with an understanding of health functions, organization, and practices, and with knowledge and skills related to health services and goals. Content areas recommended to achieve this objective should stress instruction in selected fields basic to public health. These should include the following fundamental areas of knowledge: -the nature of man and his total environment (physical and bio-social), and his interaction with this environment as it affects his health; -the basic techniques of investigation, measurement, and evaluation, including biostatistics and epidemiology as a means of determining community health needs, programs, and progress; -the basic techniques of administration (organization and management), particularly as applicable to comprehensive health programs; -the economic, political, legal, cultural, and social dimensions and forces of the community as they relate to health programs and services; the techniques of describing and analyzing these dimensions and forces; 538 VOL. 59, NO. 3. A.J.P.H.
6 GRADUATE PROGRAMS IN COMMUNITY HEALTH EDUCATION -knowledge of current and emerging community health problems wvith specific reference to existing methods of intervention (control) and needed research; -knowledge of health and related organizations and agencies with relevant health objectives and their interrelationships; -the application of the above in the planning, conduct, and evaluation of community health programs. (2) To provide the community health education specialist with an understanding of the nature of education and the learning process, and the factors which influence or affect these, particularly as they relate to health in individual, family, and community settings. Content areas recommended are: -the educational process with particular relevance to adults in various community settings, incltudinig: interrelationships of attitudes, behavior. and understanding; the process of decision making; values, motives. and goals of the learner and the eduicator and how these affect learning; social slipport; perceptions: socialization; participation and involvement of the learner; -the behavioral change process with particular emphasis on theories and models of change; the eduicational approach; the processes of communication, diffusion, and adoption of newv ideas and practices; and the role of the educator in the process of change; -the nature of group processes with particuilar reference to the dynamics of grouips, leadership, and membership roles, "groupcarried changes," i.e., how members of groups influence each other, group development, and institutional behavior; -educational methods related to the learning process, especially criteria for selecting specific methods, the unique characteristics and relative effectiveness of various methods. skills in the use of a variety of methods, community organization as a method, and evaluiation techniques; -community analysis with special reference to commuinity description, factors, and items essential to the educational process, analysis of communication pathways, of problems of influence, and of distribution of power. survey methods, delineation of institutional roles in health education, and the relation of these community items to the learning process, to behavioral change, and to the eduicational approach. (3) To help the community health education specialist understand and develop skills in his functions, role, and relationships to other workers, and particularly to those in the health professions. Educational activities related to this objective include: organizing and conducting pre- and inservice training programs for health educators and for other health personnel; participating in program planning with other disciplines; planning and evaluating the health education component of a program; analyzing community data in preparation for designing a program; developing cooperative community efforts in relation to a specific program; providing consultation to other health workers on the use of the educational approach, and recruiting staff for the agency. (4) To prepare community health education specialists to participate in program planning; to understand and take leadership responsibility in planning, carrying out, and evaluating the educational component of community health programs; to assist in developing needed inservice education (staff education), and to contribute to the health aspects of school and adult education. Suggested content includes: -community health program planning (a) the nature of the planning process; (b) contributions of the community health educator to over-all program planning, with special emphasis on the educational aspects: (i) information giving, i.e., salient facts regarding interests, attitudes, beliefs, and practices of target groups; (ii) information requesting, i.e., raising pertinent quiestions regarding educational objectives and procedures: (iii) participation in decisions regarding program plans: (c) the nature of program objectives witl particular attention to the educational objectives and components of programs. -leadership role in planning the educational aspects of particular health programs (a) methods of defining educational objectives; MARCH,
7 (b) analysis of forces and factors likely to affect change of behavior in practice; (c) analysis of characteristics of target groups; (d) designs for educational programs; (e) designs for evaluation procedures, particularly as they relate to modification in behavior, changes in beliefs, and measurement of levels of knowledge and understanding of target groups; (f) methods of community analysis to identify communication patterns, leadership, and decision-making mechanisms in families and community groups. -implementation and conduct of the educational aspects of the plan: (a) leadership role of the community health education specialist, identification of his functions, helping others to contribute; (b) coordination of educational efforts of various individuals and groups involved in the program; (c) identification and assessment of barriers to progress; (d) assessment of educational progress and needed program modifications. -evaluation of the total program with particular attention to (a) modification of health practices (behavior) of people as related to the stated objectives; (b) modification of understanding, knowledge, attitudes, and beliefs related to these practices. -inservice education programs (a) the design of educational programs particularly in regard to the processes and methods employed; (b) guides for planning, purposes and objectives, and needs. -the health aspects of school and adult education (a) role as a resource person to schools in improving the health education aspects of the curriculum; (b) interpretation of health problems and needs in the community to school and adult education groups, and implications for content; (c) relation of community health programs to school and adult education groups, and implications for planning. 540 (5) To develop competence in administrative management, supervision, and consultation. Content relates to: the philosophy and processes of administration, supervision, and consultation; bases for the formulation of policies and procedures; recruitment and supervision of health education personnel; preparation of job descriptions; office management principles and techniques; and limitation and delegation of responsibilities. (6) To provide community health education specialists with an introduction to research methods applicable to community health education. This includes: knowledge and interpretation of pertinent research and its implications for practice; knowledge of and skill in the use of the problem-solving approach and scientific method; knowledge of and skills in basic data-collection methods; knowledge and skill in using some commonly applied statistical methods; the nature of research and how to conduct small-scale studies. (7) To develop a sense of mission in carrying out the functions of the community health education specialist. Content suggested includes: knowledge of the history of health education and the contributions of pioneers and programs; bases for a philosophy of health education; characteristics of a profession, particularly a service profession; and the responsibilities of members of a profession for its improvement and development. c. Time Requirements-Master's Degree In no case should the length of total courses required for the master's degree be less than one academic year. A candidate may be required to spend two academic years or more for the completion of didactic, laboratory, and field studies, if such requirement is consistent with: (1) the needs of an individual student; (2) the mission and objectives VOL. 59. NO. 3. A.J.P.H.
8 GRADUATE PROGRAMS IN COMMUNITY HEALTH EDUCATION of the department or program area in relation to the degree in question; (3) sound academic and pedagogic practice; and (4) the general pattern in other parts of the university. D. Jointly Planned and Operated Phases of the Education Program Each department or program area-as consistent with its stated mission and objectives should develop a pattern of joint participation with other institutions and agencies to provide the kinds of teaching and learning experiences it deems appropriate for its degree candiates, faculty, and staff. (a) Supervised Field Experience To accomplish the required field experience, the school term may need to be extended and more faculty employed to carry out the increased amount of individual planning and personal supervision required to provide such field experiences effectively. The purpose of such experience is to provide opportunity for supervised field analysis, applications, and foundations of community health practice. The time required may vary according to the experience of each candidate and the subject. With supervised field training experience, the specific relationships of the department or program area to the field agency should be clearly defined and understood by all parties concerned. (b) Preparation of Health Educators for Service on College Faculties and Other Educational Institutions Demands are increasing for community health educators to fill faculty positions in colleges and universities. For some students experiences in these institutions in teaching, training, consultative, and research roles may be desirable. To accomplish this, similar relationships to those described for supervised field experience will need to be established. In addition, courses in education may be required, either by the institution or the state or regional teacher accreditation bodies. (c) Continuing Education The department or program area should be active in continuing education of academicians and practitioners in community health education, as well as of other health personnel. It is desirable and appropriate that operating agencies and the department or program area cooperate to develop and conduct continuing education activities. E. Research The department or program area should promote appropriate faculty research in health education, and should be able to identify the extent and scope of its faculty involvement in research. Much of the curriculum taught and most of the health activities carried on in communities are or will be based on the results and effects of research, organized demonstrations, and basic studies conducted in other related sciences and education. Therefore, individual and collaborative research, including interdisciplinary research and designed demonstration (with built-in evaluation) should be the principal method of developing and advancing the content and practice of health education. IV. EVALUATION Objective Self-Evaluation Departments or program areas offering preparation in community health education should develop MARCH,
9 various approaches to self-evaluation. Attempts at self-evaluation of department or program progress and success should be undertaken with as much objectivity as possible, keeping in mind its stated mission, objectives, and purposes. Success should be acknowledged by the accomplishments of its faculty and by the careers of its graduates, as demonstrated in service, publications, and research. Postgraduate Fellowships at Miami University The Division of Family Medicine at the University of Miami School of Medicine is offering postgraduate fellowships in academic Family Medicine. Sponsored by the Family Health Foundation, these fellowships are being offered to (1) residents who are completing their training programs; (2) physicians with experience in family practice; (3) those with teaching appointments in schools of medicine, community hospitals, or health centers. For further information, write: Director, Division of Family Medicine, University of Miami School of Medicine, Box 875, Biscayne Annex, Miami, Fla VOL. 59, NO. 3, A.J.P.H.
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