Value Complexity in Health Education

1
Value Complexity in Health Education

• A Systems Theoretical Contribution to Value
  Clarification

2
What values?

• Health is a dynamic state of physical, mental
  and social well-being, and not only the absence
  of disease and disability (WHO, 1947, 1986)
• A healthy life is not only a question of treating
  or preventing disease but also a question of the
  quality of life and living the good life
• A good life is not just being alive, but living
  for the realisation of individual and social
  values although we may ask, what values?

3
Consequences

• Decisions are no longer based on traditional
  norms or on objective knowledge, choice of
  rational are contingent and subject to discussion
• Health implies individual and social value
  complexity
• Conflicting values

4
Educational challenges

• Uncover the values of the participants in health
  promotion and education
• Build competences to expose and reflect on the
  value complexity inherent in health promotion and
  education

5
General objective

• By observing two health-educational development
  projects
• To develop/modify a model to describe the
  complexity of values in health education
• To propose criteria for building competencies for
  value clarification in health education

6
Health education

• Health education is communication that intends
  learning about health and promote participation
  in healthy lives
• Learning and teaching are no longer based on the
  transfer of knowledge and values individuals are
  formed through self-referential processes

7
Ideology

• Health education need a core of value
  clarification to provide the action competence
  needed for participatory education
• The purpose is to reflect on the values
  facilitating health promoters, as a contribution
  to participatory education

8
Participants and settings

• Values in Health Education and Promotion in
  Greenland (1.1.2004-31.12.2006)
• 22 health professionals from different
  educational practices ?12 local value projects
• Values in Public Health Nursing and Primary
  Schools in Copenhagen (1.4.2004-31.3.20007)
• Phase 1 workshops participating 142 health
  visitors
• Phase 2 ? 16 PHN ? 12 projects at primary schools

9
Demand for clarifying

• What do the participants say about values?
• How do they relate value to their concept of
  health and vice versa?
• How do they manipulate communication with the
  values?
• How do they include the values of their target
  group and how do they observe and reflect on
  values in their healthy dialogues?

10
Findings (I) Value conflicts

• Promoting healthy learning processes conflicts
  with maintaining social control
• Having an educational background in biomedical
  science conflicts with working with a value
  clarified concept of health
• Connecting with powerful guidelines of health
  behaviour and lifestyle conflicts with
  participation in decision making

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Findings (II) Values

• Health educators do not reflect on their own
  health and health promotion as learning processes
  through their professional work
• Values tell more about the social context to
  which they are connected than the educators own
  values
• Health educators can conceptualize their
  comprehension of values of their target groups
  but in practice they use lifestyle oriented
  methods

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Findings (III) Contingency

• Participation means contingency
• Educational norms are artificial
• The necessary approach is contingent because
  under different conditions the participants may
  have to accept different norms
• Risk means lack of control
• Social control fix traditional values of problem
  solving for others

13
Theoretical model

• Values
• Complexity
• Competencies

14
Values

• Value is an operation with a distinction between
  /-, where the positive side of the distinction
  is preferred to the negative
• Values are generalized, individually symbolized
  perspectives which allow one to prefer certain
  states or events (Luhmann)

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Valuing and clarifying

• Values are distinctions made by observers
• Observing the observer makes it possible to
  distinguish between
• Valuing (as an observation) and value (as a
  distinction)
• Valuing (first order observations) and clarifying
  (second order observations)

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Social values- communicational constructs

• Interactions e.g. dialogues with citizens
• Organizations e.g. PHN
• Functions e.g.
• Treatment (/- disease)
• Social service (/- help)
• Education (/- learning outcome)
• Care (/- charity)

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Complexity- important distinctions to
conceptualize

• Valuing (1.order obs.) vs. clarifying (2.order
  obs.)
• Personal values vs. generalized values
• different functions and role identity
• different social and cultural (semantic) contexts
• Social values vs. mental values (the sense of
  individual values)
• important in building individual beliefs and in
  the interpretation of emotions as well as social
  norms

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Competence

• Competence is second order knowledge, i.e.
  knowledge of the conditions of knowing (implying
  knowledge of knowledge)
• Competence is reflexive or situated knowledge
  implying the capacity for self-observation
  (Qvortrup)

19
Value clarification as competence

• Reflecting on the diversity of values in order to
  build a professional capacity for coping with
  value complexity
• No professional identity is based on stable
  values
• No educational practice is based on common values

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Conclusion

• Value clarification competence is having the
  ability to identify values and conflicts of
  values relevant to different situations
• Health educators are not only capable of
  categorizing what they see they also have the
  ability to consider their observations together
  with their own values

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Karen Wistoft

• Research Programme for Environmental and Health
  Education
• Department of Curriculum Studies
• The Danish University of Education
• Tuborgvej 164, DK-2400 Copenhagen NV
• kawi_at_dpu.dk