Academic journal article Research and Theory for Nursing Practice

Evaluating the Effect of Teaching Modules on Underserved Clients' Perceived Health

Academic journal article Research and Theory for Nursing Practice

Evaluating the Effect of Teaching Modules on Underserved Clients' Perceived Health

Article excerpt

Underserved individuals need comprehensive health care. Educational resources that meet health care needs can promote wellness. This descriptive study evaluated effects of preferred teaching modules on perceived health of underserved clients of a nurse-managed center. Participants (N = 101) were between 19 and 61 (M = 38.7); the majority was female (68.3%) with a high-school education (M = 12.17). Most participants (65%) identified health education as very important; 92% used at least one teaching module. Age, gender, and education were not related to importance of health education. Use of various teaching modules was positively correlated with perceived improved health (p < .05). Participants who used a combination of videos and pamphlets reported the greatest improvement (p < .000).

Keywords: health education; underserved; perceived health

Limited access to health care due to lack of health insurance and low income is a widespread and continuing problem across the United States. According to Healthy People 2010 , more than 44 million individuals in the United States do not have health insurance (U.S. Department of Health and Human Services [USDHHS], 2000). Over 80% of uninsured individuals under the age of 65 are members of working families who receive no insurance benefits with their job, and purchasing a policy could exceed 10% of the family income (Institute of Medicine [IOM], 2003). Often these individuals are reluctant to seek health care, resulting in: (a) fewer preventive services (Himmelstein &Woolhandler, 1995; IOM, 2002a; IOM, 2002b; Orne, Fishman, Manka, & Pagnozzi, 2000; Robert Wood Johnson Foundation [RWJF], 2003; USDHHS); (b) no consistent care for chronic conditions (IOM, 2002a; Orne et al.; RWJF); (c) inconsistent access to medications (IOM, 2002a); (d) receiving health services too little and too late (IOM, 2002a); and (e) higher mortality rates (Franks, Clancy, & Gold, 1993; IOM, 2002b; RWJF).

At-risk individuals need comprehensive health care not only for immediate medical problems, but also for health promotion and disease prevention. One way to promote wellness is to provide educational resources to meet health-care needs. The provision of health-education strategies should be synonymous with health promotion (Steckler et al., 1995). Educational strategies may focus on improved lifestyles and/or may be tailored to meet specific acute or chronic health needs. Such educational strategies can affect knowledge, attitudes, and behaviors, which may result in measurable changes in wellness (Steckler et al.).

Health care providers of the underserved have opportunities to influence knowledge and attitudes about adopting healthy behaviors through positive interactions and provision of health education. Effective education may lead to earlier detection of disease (Glanville, 2000), improved health behaviors (Kessler & Alverson, 2003), better clinical outcomes, and decreased medical costs by minimizing complications, hospitalizations, and health care visits (Glanville; Kessler & Alverson). Thus, the purpose of this descriptive study was to evaluate the effect of preferred teaching modules on the perceived health of underserved clients seen at a nurse-managed center.


Nurse-managed centers "provide communities with improved access to high quality primary health care and health promotion programs where previously few or no services were available" (Clear, Starbecker, & Kelly, 1999, p. 11). Often these centers provide care to underserved and uninsured clients who otherwise have no access to comprehensive health services. Nurse-managed centers provide an opportunity for holistic care that includes health-promotion activities while meeting the immediate acute medical needs of clients (Pender, 1996). These primary prevention services embrace the need for health education as essential for holistic care.

Health-educational interventions have potential for yielding improvement in health status (Steckler et al. …

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