100 Years of the American Public Health Association's Public Health Education and Health Promotion Section: Celebrating the Past, Forging the Future.

The American Public Health Association's Public Health Education and Health Promotion (APHA PHEHP) Section celebrates its 100th anniversary by reflecting on its humble beginnings and early contributions to the field of health education. This article highlights the often-unsung history of our field and its fledgling beginnings, which is important to scholars and students alike. First codified as the Health Education and Publicity Section in the early 1920s, we trace the history and challenges of using new modes of publicity such as motion pictures and innovative exhibits to help curb the spread of infectious diseases (e.g., tuberculosis, venereal disease). Evart G. Routzahn, credited as the Section's father, worked tirelessly to increase the Section's visibility (renamed the Health Education Section in 1927 and the Public Health Education and Health Promotion Section in 1990) and in advancing the professionalization of health education during a time when there were no formal professional preparation programs in health education. Over the years, the Section has played significant roles in strengthening the practice of health education and communication; advancing APHA's overall leadership, infrastructure, and governance; and contributing to the unified voice and advocacy for the health education profession and health equity. We conclude by describing contemporary initiatives that reflect the continued spirit and vibrancy of the Section in setting the stage for the next 100 years.

U.S. Policies for school health education: opportunities for advocacy at the local, state, and national levels.

Children in K-12 settings comprise roughly one fifth of the population of the United States and are a cohort that has long drawn the interest of health educators. Early education and prevention efforts reduce human suffering, contribute to preparation for classroom learning, affect long-term health, and contain health costs due to preventable diseases. Despite the possible positive impact of a comprehensive approach, no broad-based federal legislation mandates regular school health education. Instead, the current state of school health education policy is a cobbled-together set of policies subsumed under existing laws. The purpose of this article is to provide information about the key legislation that is being used to promote school health education in the United States. Furthermore, the authors suggest opportunities for lobbying for the continuance of existing legislation and advocating for state and local operationalization of these policies. Finally, health educators are rallied to consider raising the issue of advocating for a more complete legislative strategy for school health education.

The Patient Protection and Affordable Care Act: opportunities for prevention and advocacy.

The Patient Protection and Affordable Care Act has come under intense scrutiny about its mandate for individual health insurance purchase, yet it has received little praise in the popular press for its prevention measures. Irrespective of the Supreme Court's decision regarding the "individual mandate," it is important for public health professionals to advocate for the preservation of the prevention and wellness provisions in the current law. The article addresses the Supreme Court's hearing for the "individual mandate," the likely impact of the general election in 2012, and specific prevention components of the law that should be championed by health education and health promotion advocates.

Provider practices in prediabetes intervention and diabetes prevention: application of evidence-based research in the medical office setting.

A cross-sectional study was performed to determine if evidence-based research in prediabetes management is utilized in the medical office setting in an effort to reduce the incidence of type 2 diabetes, and to determine whether any particular demographic variables including body mass index (BMI) and provider type (physician and nonphysician) predict referrals for prediabetes management (P = .05). Electronic medical records (n = 82 317) were examined for International Classification of Diseases (ICD) codes and keywords disclosing a diagnosis of prediabetes. The records of individuals with diagnosed prediabetes were subsequently examined for keywords and ICD codes for lifestyle intervention. Logistic regression was utilized to determine whether any particular demographic factors significantly predicted whether medical providers will provide recommendations or referrals for lifestyle management of prediabetes. Age, BMI, and race were found to be significant predictors for recommendations/referrals, although overall rates of recommendation or referral were poor. Provider education and enhancements in organizational policy related to referral procedures and continuity of care from the clinical setting to the community health setting are crucial in promoting early interventions in prediabetes to offset the current projections for an increase in diabetes incidence.

Advocacy 2.0: advocating in the digital age.

Advocacy for the individual health needs of others, for the health of the public, and for the profession have always been critical underpinnings of the field of health education. The explosion of technology and freedom of the Internet provide a multitude of possibilities for revitalized advocacy efforts. This article suggests just a few examples of how we might engage in Advocacy 2.0. Developing advocacy campaigns that use both tested and untested methods gives us an opportunity to achieve new victories in health education advocacy.

Educating for advocacy: recommendations for professional preparation and development based on a needs and capacity assessment of health education faculty.

An electronic survey was used to conduct a needs and capacity assessment of health education faculty to determine the extent to which advocacy instruction is present in undergraduate and graduate curricula in health education and to identify faculty members' needs and capacity to provide professional preparation and development experiences related to advocacy. An analysis of the results reveals that most undergraduate and graduate health education programs include advocacy instruction. Although faculty believe advocacy and instruction related to advocacy are important, many lack advocacy-related professional preparation and development experiences and do not participate in advocacy-related training initiatives and advocacy activities. There is wide variability in faculty confidence in their competence to provide advocacy instruction. Partnerships among professional organizations, health education practitioners, university faculty, individuals engaged in policy advocacy initiatives, and policy makers are needed to enhance the capacity of university faculty to provide professional preparation and development experiences related to advocacy.

Developing effective written communication and advocacy skills in entry-level health educators through writing-intensive program planning methods courses.

Written communication is a requisite skill for practitioners in the field of health education. Advocacy skills are now considered to be both a professional competency and an ethical responsibility. Given that many advocacy strategies involve written communication, it makes sense that the skills of writing and advocacy be developed concomitantly and within a writing-intensive class. The purposes of this article are twofold: (a) to describe the role of writing-intensive program planning methods courses in the development of written communication and advocacy skills in entry-level health educators and (b) to suggest strategies for planning, implementing, and assessing writing-intensive assignments and instructional activities designed to develop students' written communication and advocacy skills. Multiple examples of writing assignments are presented that can be used in helping students in developing their critical thinking, writing, and advocacy skills.

Relationship of pulmonary function among women and children to indoor air pollution from biomass use in rural Ecuador.

Approximately half the world uses biomass fuel for domestic energy, resulting in widespread exposure to indoor air pollution (IAP) from biomass smoke. IAP has been associated with many respiratory diseases, though it is not clear what relationship exists between biomass use and pulmonary function. Four groups containing 20 households each were selected in Santa Ana, Ecuador based on the relative amount of liquid petroleum gas and biomass fuel that they used for cooking. Pulmonary function tests were conducted on each available member of the households 7 years of age. The pulmonary functions of both children (7-15 years) and women (16 years) were then compared between cooking fuel categories using multivariate linear regression, controlling for the effects of age, gender, height, and exposure to tobacco smoke. Among the 80 households, 77 children and 91 women performed acceptable and reproducible spirometry. In multivariate analysis, children living in homes that use biomass fuel and children exposed to environmental tobacco smoke had lower forced vital capacity and lower forced expiratory volume in 1s (P<0.05). However, no significant difference in pulmonary function was observed among women in different cooking categories. Results of this study demonstrate the harmful effects of IAP from biomass smoke on the lung function of children and emphasize the need for public health efforts to decrease exposure to biomass smoke.

Prevalence and risk factors for protozoan and nematode infections among children in an Ecuadorian highland community.

In order to create a parasite prevention program for Santa Ana, Ecuador, we worked with local physicians to identify the prevalence and risk factors for intestinal parasitic infection among children. Two hundred households were randomly selected and asked to submit three stool samples from a selected child. Information from direct observation and questionnaires was used to determine environmental and behavioral risk factors for parasitic infection. Prevalence of any parasitic infection was 65.6% of the 189 children who submitted fecal samples. Parasitic infections included Entamoeba histolytica/E. dispar (46.6%), Giardia lamblia (18.5%) and Ascaris lumbricoides (20.1%). In a multivariate logistic model, risk factors (P<0.05) for E. histolytica/E. dispar included >1 month since antiparasitic treatment, not adding chlorine to drinking water, children not washing their hands before eating, and having a fewer number of electrical appliances in the home. The risk factor identified for G. lamblia was children not washing their hands before eating. Risk factors for A. lumbricoides included >6 months since antiparasitic treatment and having a fewer number of electrical appliances in the home. This study may have implications for other communities throughout the developing world.

Advocacy 101: getting started in health education advocacy.

Advocacy for the public's health and for the profession are widely recognized as responsibilities of health educators. Increasing emphasis on advocacy by professional organizations has peaked the interest of health educators, yet knowing where to begin as an advocate is, to many, a mystifying process. This article provides basic advocacy terminology, dispels concerns about participating in advocacy activities, and provides a practical and stepped approach to becoming an effective advocate. A tiered approach is used in relation to the advocacy strategies of voting behavior, electioneering, direct lobbying, grassroots lobbying, Internet use, and media advocacy to help individuals in their quest to begin or enhance their engagement in advocacy. A compendium of highly accessible resources is also provided. Finally, this article provides motivation for the beginning advocate.