〈사례보고〉 건강증진을 위한 참여 학습의 적용 사례

국문 초록 (Abstract)

저자들은 건강증진 사업에서 지역사회 역량강화를 위한 참여 학습을 적용하고 과정을 평가하였다. 먼저 참여 학습의 적용 가능성(feasibility)을 시험하기 위한 파일럿 프로그램을 수행하였다. 지역사회역량강화 시범사업의 건강위원, 지역사회 역량강화 사업을 위한 코디네이터 양성 교육 참가자, 그리고 건강교육진행자에 의한 건강교육 프로그램 참가자를 대상으로 3-4주에 걸친 참여 학습을 진행하고 교육 후 설문조사를 실시하였다. 그 결과 ‘참여 학습 프로그램이 유익했는지’, ‘재미있었는지’, ‘진행방식이 적절했는지’, ‘행자의 진행이 적절했는지’, ‘다른 사람에게 참여를 권하겠는지’의 질문에 대하여 80% 이상이 "그렇다‘ 또는 ’매우 그렇다‘의 긍정적인 답변을 하였다.
이를 토대로 지역사회 역량강화를 통한 건강증진사업인 경상남도의 건강플러스 행복플러스 사업의 건강위원 역량강화교육에 본격적으로 참여학습 방법을 적용하였다. 첫 단계인 주제의 선정(듣기)은 지역건강토론회로 대신하였다. 두 번째 단계인 문제 제기(대화)에서는 우선순위 선정과 건강문제 해결을 위해 전략과 세부사업을 의논하였다. 그 결과 자신들이 선정한 우선순위 영역에서 지역사회에서 건강생활이 실천되지 않는 이유를 고려하여 향후 건강위원회가 무슨 일을 해야할지 다양한 전략을 잘 도출하였다. 세 번째 단계인 행동-성찰-행동은 현재 진행 중이다. 결론적으로 저자들은 지역사회 역량강화를 통한 건강증진 사업의 여러 대상에 참여 학습을 성공적으로 적용할 수 있었다.

다국어 초록 (Multilingual Abstract)

Objectives: This study was conducted to develop a participatory learning process and apply it to community empowerment for health promotion.
Methods: The participatory learning sessions were composed of three stages according to the modified Freirean model of empowerment education. Stage 1 of generating themes (listening stage) was replaced with a community health forum. Stage 2 of problem-posing was executed via a two-session small group brainstorming discussion for selecting priority community health problems and strategies to solve them. Stage 3 of act-reflect-act, the implementation of the chosen strategies, is ongoing. We tested the feasibility of the participatory learning processes in the pilot programs for health education. Then, 14 Myeon (or Dong) Health Committee members used them in Health Plus Happiness Plus projects for community empowerment to achieve health equity in Gyeongsangnam-Do, Korea.
Results: In the pilot program for feasibility, more than 80% of the 95 participants gave positive responses to evaluation questionnaires after three or four participatory learning sessions. Health Committee members successfully selected various strategies relevant to their communities with facilitation, but without any teaching from outside professionals.
Conclusions: We successfully applied the participatory learning process to health promotion. However, more studies are warranted to evaluate its long-term applicability.

목차 (Table of Contents)

• Abstract
• 서론
• 대상 및 방법
• 연구 결과
• 고찰
• 요약
• 참고문헌

참고문헌 (Reference)

1 홍은광, "한국 민중교육의 역사적 전개와 프레이리 교육사상"

2 고상준, "참여와 자치를 위한 시민교육 필드북" 서울, 열린사회 시민연합 34-268, 2004

3 이보영, "지역사회 여성암 검진 네비게이터 교육 프로그램 개발 및 효과 분석" 한국농촌의학.지역보건학회 34 (34): 214-222, 2009

4 주애란, "중학생의 인터넷게임중독 예방을 위한 임파워먼트교육프로그램의 효과" 한국간호과학회 40 (40): 255-263, 2010

5 송창석, "새로운 민주시민 교육 방법론" 25-32, 2005

6 김윤미, "모유수유 임파워먼트 프로그램이 완전모유수유에 미치는 효과" 한국간호과학회 39 (39): 279-287, 2009

7 Matoro-Kiria J, "Why participatory is an effective approach in training for social change"

8 Rindner EC, "Using Freirean empowerment for health education with adolescents in primary, secondary, and tertiary psychiatric settings" 17 (17): 78-84, 2004

9 The editors, "The scope of health behavior and health education" John Willey & Sons, Inc 10-, 2008

10 Stuttafor M, "The learning component of participatory learning and action in health research: reflections from a local Sure Start evaluation" 17 : 1351-1360, 2007

11 Hinton A, "The community health advisor program and the Deep South Network for Cancer Control-health promotion program for volunteer community health advisors" 28 (28): 20-27, 2005

12 Eisen A, "Survey of neighborhood-based, comprehensive community empowerment initiatives" 21 (21): 235-252, 1994

13 Wallerstein N, "Powerlessness, empowerment, and health: implications for health promotion programs" 6 (6): 197-204, 1992

14 Kiessling, "Participatory learning: a Swedish perspective" 90 : 113-116, 2004

15 Bradley S, "Participatory learning"

16 Rudd RE, "Learner developed material: an empowering product" 21 (21): 313-327, 1994

17 Minkler M, "Improving through community organization and community building, In Health behavior and health education" John Willey & Sons, Inc 287-288, 2008

18 Laverack G, "Improving health outcomes through community empowerment: a review of the literature" 24 (24): 113-120, 2006

19 Airhihenbuwa CO, "Health promotion and the discourse on culture: implications for empowerment" 21 (21): 345-353, 1994

20 Israel BA, "Health education and community empowerment: conceptualizing and measuring perceptions of individual, organizational, and community control" 21 (21): 149-170, 1994

21 Wallerstein N, "Empowerment to reduce health disparities" 30 (30): 72-77, 2002

22 Hohn MD, "Empowerment health education in adult literacy: a guide for public health and adult literacy practitioners, policy makers and funders" 77-, 1998

23 Bergsma LJ, "Empowerment education: The link between media literacy and health promotion" 48 (48): 152-164, 2004

24 Wallerstein N, "Empowerment education: Freire's ideas adapted to health education" 15 (15): 379-394, 1988

25 Leyshon S, "Empowering practitioners: an unrealistic expectation of nurse education" 40 (40): 466-474, 2002

26 Flynn BC, "Empowering communities: action research through healthy cities" 21 (21): 395-405, 1994

27 Manandhar DS, "Effect of a participatory intervention with women's groups on birth outcomes in Nepal: cluster-randomised controlled trial" (364) : 970-979,

28 Rapid Business Improvement, "Cone of experience"

29 Raeburn J, "Community capacity building and health promotion in a globalized world" 21 (21): 84-90, 2007

30 CART Project Team, "Community action for health promotion: a review of methods and outcomes 1990-1995" 13 (13): 229-239, 1997

31 Laverack G, "Building capable communities: experiences in a rural Fijian context" 18 (18): 99-106, 2003

32 Hardy CM, "African American Community Health Advisors Trained as Research Partners-recruitment and training" 28 (28): 28-40, 2005

33 Cooper H, "A trial of empowerment-based education in type 2 diabetes-Global rather than glycaemic benefits" 82 : 165-171, 2008

34 Pretty JN, "A trainer's guide for participatory leaning and action" Nottingham, Russel Press 16-17, 1995

35 Laverack G, "A planning framework for community empowerment goals within health promotion" 15 (15): 255-262, 2000

36 김진석, "<사례보고> 농작업 환경개선을 위한 한국형 참여형 개선활동 교육(PAOT)의 개발과 실제 적용 사례" 한국농촌의학.지역보건학회 35 (35): 417-427, 2010