Student Health Education Teams in Action

Mary Dubois

At first glance, it looks like any other adult education class, multiage, multicultural, and multilevel. Upon closer inspection, however, questions arise. Who is the teacher? Is it the middle-aged woman at the board? Could it be the young man who appears to be taking notes? Perhaps it is the older woman who is speaking? When entering the classroom, the casual observer would notice a group of adults ranging in age from mid 20's to early 70's. During the discussion everyone takes part. The material they are talking about comes from the ABE Health Curriculum Framework, and the students are members of the Health Team at a weekly meeting. The woman at the board is this week's leader, Amelia. She is a student is an ABE GLE (Grade Level Equivalent) 4-5.9 class, and she moderates the discussion and writes the brainstorming results. The young man is Jose from an ESOL SPL (Student Performance Level) 2-3 class and is he taking notes of the meeting.
The older woman voicing a suggestion, Martina, just moved from an ABE GLE 0-3.9 class to a GLE 4-5.9. She is making a point during the discussion.

The teacher/facilitator has just distributed a copy of the ABE Health Framework to each of the eight team members. While looking over the framework, one of the team members notices a diagram illustrating the importance of good health in every aspect of life. The team decides
to make a poster of the diagram to display on the Health Bulletin Board. They discuss making a new heading which would be easier for all students at the center to understand. "I need a compass," says David, an ESOL 2-3 student from Portugal. He wants to draw and enlarge the diagram, which includes a sizeable circle. The teacher/facilitator goes to the GED Classroom to look for one. Jose, David's classmate from Cape Verde, suggests making a compass. Jose's wife, Helena, and Winnie from China, both students in ESOL SPL 6-8, take two pencils and some string and make a compass. Amelia, the leader, needs a ruler to measure out the lines for the heading. All of this is accomplished without any input from the facilitator. The students drive the process.

After the poster is completed, the team practices their cancer presentation. They are researching cancer on the Internet in response to a health issues survey they developed for all students at the center to complete. Initially, the survey was posted on newsprint and students voted during class break time. When checking the results, the team felt that the numbers were low and perhaps invalid. They decided to ask students to complete a paper copy of the survey during class (see Initial Assessment in appendix). This produced more accurate results. The cancer presentation includes a two-sided paper with a drawing done by David illustrating "What is Cancer?" The team reviews the language to assure understanding of all classes at the center, which range from ESOL 0-1 to GED. On the reverse is a typed list of prevention tips augmented with clip art drawings (see appendix). After practicing, the team decided to pair up for the class visits. They talk about which team members would be most effective in each class in terms of translation requirements of ESOL. Next they discuss the best time and day to visit the classes.

The last item on the agenda is the Health Team T-shirts. A member of the Center's Advisory Board had referred the team to the adjacent public junior high for possible printing of the shirts. The Advisory Board at the program is composed of representatives from community agencies, business people from the community, the program's director, counselor, and volunteer coordinator, a state representative, and students from the Adult Learning Center. After several phone conversations and visits regarding colors and graphics, the school declined the job. One of the team members now proposes making their own shirts using the computer and iron-on material for the graphics. This is enthusiastically received and will be the plan for the next meeting.

The Health Team concept is a participatory model. A former health team member describes the process. Sandra, a dentist in her native country of Colombia writes, "I became involved in the health team in a voluntary way. One of my teachers gave me an application. I filled it out and after that we had a meeting to know each other. We started to plan how to do good things." All students at the center are offered the opportunity to join the Health Team. The application is modeled on an employment form (see appendix). After the teacher/facilitator reviews the applications, interested students gather for an "interview." Potential members meet with current or past team members and the teacher/facilitators. The former team members explain the duties of the team and offer examples of the work previous teams have done. Candidates answer questions such as: Why do you want to join the team? How do you think you can help the team? Do you have any health-related experience? Do you understand the way the team works? Do you have any questions for us? Based on both the application and the interview, the facilitator and former team members vote on candidates for the current team. Although the members receive a stipend, this is not mentioned until after the members have been chosen. At the first meeting, the new members are told about the stipend as well as the fact that it is based on attendance and participation. Members receive the stipend at the conclusion of the school year.

Health topics are identified by surveying all the students at the center. Team members research the health issues indicated by the survey results. Sandra reports, "We did research into depression, asthma, high blood pressure, nutrition, diabetes and quit smoking. We made brochures, contests, newsletters, bulletin boards, presentations, and we explained the topics in an easy way for everyone. We went to other schools and performed a skit. We shared coloring books (teaching about asthma) and crayons with children." The team also arranged for Public Health nurses to come to the center to check blood pressure. To follow-up they arranged for a visit by the mobile health van for additional screenings. Team members called and scheduled both visits. They notified all students and staff and also developed a timetable for classes to be checked. The team escorted each class to the screenings and wrote thank you notes to the health practitioners. All of this work was accomplished during weekly Health Team Meetings.

At first the new team members are a little nervous about taking charge. Their previous academic experience, especially for ESOL students, is to sit quietly without much participation while the teacher runs the class. In addition, some students are not confident in their ability to speak English. However, they recognize right away that the experience of speaking and writing English will improve their skills in both areas. Once they grasp the concept that they are in charge, and the teacher is a facilitator who stays in the background and is used as a resource, a transformation takes place. The team members work together in a cooperative fashion or independently on an aspect of a project they feel strongly about. They come up with ideas, they decide how to address the health issues, i.e. developing a brochure, video, pamphlet, newsletter, or bulletin board, arranging for guest speakers, contacting community health practitioners, etc. In addition, their research is the basis of a curriculum, which is distributed to all staff members. The curriculum contains an initial assessment as well as a post assessment. The initial assessment can be a survey, and true-false "quiz", a brainstorming discussion, or a K-W-L process where students list what they Know (K) about a topic as well as what they would like to know (W). At the conclusion, they will note what they have learned (L). The post assessment may be the initial assessment, a survey, or a product. Last year's team was concerned mid-year as to whether they were reaching the learners at the center. They decided to develop a survey asking for additional learner input and suggestions.

Overall, the participatory concept meets the needs and requirement of adult learners. It touches upon the Freirean approach in that learners identify problems and issues from real-life experiences and seek solutions. The theories of Malcolm Knowles, which suggest that adults move from dependency to self-directedness, draw upon their experience for learning, and want to solve problems, also support the health team model. The strongest evidence lies in the words of the student members of the health team, "I have a good time being part of health team. I learned about health, I improved my relationship with classmates, teachers, and students. I met people from different schools. Had been part of the health team was an unforgettable and nice experience."

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Mary Dubois has been associated with the New Bedford Public Schools/Division of Adult and Continuing Education's Health Team since its inception. She is currently the Curriculum Facilitator and has taught ESOL, ABE, and Adult Diploma Classes during her seven years with the program.

NEW BEDFORD ADULT LEARNING CENTER

This will follow th eprocess of the Studnet Action Health Team members.

Brainstorm Ideas

The class will have an oral discussion on "What I Know About Cancer." The teacher will list this information on the board as students offer input.

Suggested Vocabulary

• symptom

• treatment

• radiation

• chemotherapy

• risk

• screening

• prevention

• surgery

• diagnosis

• cell

• tumor

• benign

• malignant

• carcinoma

Writing

Students will write what they know about symptoms and prevention.

Survey

The class will complete a survey listing the different types of cancer and the number of people they know with each type. One class at the center will compile the surveys for the school.

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Originally published in Adventures in Assessment, Volume 14 (Spring 2002), SABES/World Education, Boston, MA, Copyright 2002.

Funding support for the publication of this document on the Web provided in part by the Ohio State Literacy Resource Center as part of the LINCS Assessment Special Collection.