The second dimension of PEN-3 model, the Educational Diagnosis of Health Behavior, has been evolved from three different models of health education. The models which are involved in the creation of the second dimension of PEN-3 model are
- Health Belief Model,
- Theory of Reasoned Action and
- the PRECEDE framework.
The second dimension of PEN-3 model consists of factors like perceptions, enablers and nurturers.
While perceptions represent the knowledge, attitudes, values and beliefs which play a large role in the motivation of the individuals, enablers are social, systematic or structural influences, which have the effect of enhancing the health beliefs and practices. Sometimes enablers may also create new barriers in the process of maintaining or changing the health beliefs and practices. Enablers like available resources, accessibility, and referrals, in connection with the health beliefs and practices largely influence the health beliefs and practices in a community. The skills and types of service available within the community to achieve the ends of the educational diagnosis can also be considered as enablers.
The second dimension of PEN-3 model is also subject to the cultural appropriateness of the health beliefs, which forms the third and important dimension of the PEN-3 model. There are three factors involved in the third dimension of the model. They are:
- positive,
- negative and
- existential.
Positive enablers may result in an individual, family or community is accustomed to health practices contributing to improved health status. It is essential that these enablers must be encouraged to develop good health among the communities and individuals. Such positive enablers resulting in good health practices are necessary to empower individuals, families and neighborhoods towards better and healthy living (Mississippi State University, 2001). An example in this direction is the creation of more primary health centers where free consultation on the ways to avoid obesity and improving the health consciousness are provided to the individuals susceptible to diabetes and heart diseases due to obesity. This is a positive enabler, which needs encouragement.
On the contrary, negative enablers would lead the individuals, families and communities to follow health practices that are harmful to keeping good health. Such resource and skills lead to unnecessary consequences in terms of affecting good health and potential loss of earning capacity of the adults. One example in this case may be cited is the proliferation of fast food outlets offering junk foods, which may increase the incidence of getting obese among the people. There must be programs evolved to educate the people the bad effects of having fast food items frequently from these outlets.
Existential perceptions are unique to particular communities, which are also having no harmful consequences. There is the need only to study such beliefs and practices as to their effect on the health of the individuals, families and neighborhoods. Efforts may be taken to improve upon these beliefs and practices so that they become beneficial to the individuals and families.
It is imperative that the health educators concentrate on both the positive and negative enablers to keep the pace of empowerment of individuals in any health program. This will have the advantage of having a higher level of sensitivity when the planners (Missisipi State University, 2001) select the most culturally appropriate health education interventions.
Thus, the PEN-3 model provides an opportunity to promote the notion of multiple truths by allowing examining cultures and behaviors. This process starts with identifying the positives and existential enablers, which represent unique cultural beliefs and practices before embarking upon the negative enablers. This encourages intervention and theorizing of positive values in preference to changing the negative values in the communities and neighborhoods (Airhihenbuwa, 2007).
References
Airhihenbuwa, C. O. (2007). On Being Comfortable With Being Uncomfortable: Centering an Africanist Vision in Our Gateway to Global Health. Web.
MissisipiStateUniversity. (2001). Health Education Models:HEALTH EDUCATION PLANNING MODELS — A REVIEW OF THE LITERATURE – PART II. Web.