Health education and the problem of knowledge

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Abstract
Helping people acquire knowledge has a place in all strategies of health promotion regardless of whether the strategy is based on the Knowledge-Attitude-Behaviour model, the Empowerment model or the Community Action model. Knowledge is one class of belief the others being opinion, dogma and myth or fallacy. Knowledge differs from the other classes in that accepting it as true can be justified. However, in the field of diet and health and in most other fields of health promotion this distinction is difficult to make in practice. The difficulties of identifying knowledge are compounded when complex scientific observations are translated into simpler statements for use in health promotion. Whether a belief is true or false is irrelevant to us effect on behaviour. The extent to which beliefs (and particularly health beliefs) affect behaviour is variable but depends on their strength and precise relevance to the individual's behaviour. Attempts to measure knowledge reveal the underlying confusion in the minds of many health educators. Instruments which purport to measure knowledge frequently treat disputable propositions as ‘knowledge’ or cover items not relevant to behaviour. Knowledge measurements from such defective instruments lack validity. It is suggested that many difficulties could be avoided if health educators contented themselves with measuring ‘beliefs’ using opinion poll type instruments.

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