**3.2 Strategies in health education**

Over time, health education has been done mostly in a traditional way by health professionals, according to health curricula. In this approach, information is given on disease, and treatments are explained in a "you have to" way. This approach is basically one-way knowledge transmission, from professionals to patients and not vice versa. Using this traditional approach, professionals scarcely have time to learn what health literacy patients already have. Patients do not have time to discuss their fears, values, and conceptions. The traditional approach to health education has brought with it serious problems. For example, recent research tells us that inadequate literacy often reveals misconceptions about different aspects of health, such as patient's erroneous understanding of how a body change in enduring diseases, long term effects of drugs or other treatments (Buston & Wood, 2000; Kaszap et al., 2000, 2006), and false beliefs about popular treatments (e.g., magical peas or liniments) with supposedly spectacular effects on blood pressure (Kaszap et al., 2000). With older men, health educators should take such health-related misconceptions and false beliefs into account and propose new strategies for health education.

Health education should not merely be transmission of information, because recipients of transmitted information may filter it through faulty premises; for example, misconceptions about bodies, health, and treatments and false beliefs about natural

Renewing Perspectives on Men's Prostate Cancer

**3.3 Evolution from existing to new educational technologies** 

Fig. 2. Older individuals' views on different aspects of health learning

contexts (among relatives and friends, even strangers) for gathering general information about health, illness, and treatment, because belonging to a group allows discussion, idea sharing, support, and maintains motivation for continuous learning. Golding (2011) reports

Literacy and Engagement Along the Disease Continuum 47

Despite well documented challenges in educational initiatives with older learners, some researchers interested in promoting older learners' health literacy are incorporating new technological tools into health teaching to enhance learning. Most older individuals are willing to learn about new technology, even to use and master it, especially if they are under 80 years old and in good mental health (Kaszap et al., 2002; Gil-Gómez et al., 2011; Jensen et al., 2010; Mackert et al., 2009; Saposnik et al., 2010; Wallington, 2008). It seems to be just a matter of having help in learning how to use new technology and having enough time to understand and practice it. Kaszap et al. (2000), in a study exploring the experiences of rural and urban older individuals with various technologies, documented elders' preference for information-gathering contexts (see Figure 2). They preferred private contexts (such as a visit to a professional's office) for gathering information on personal matters and group

products that supposedly have miraculous effects on various diseases. Before delivering health information, health professionals should seek to understand the literacy backgrounds of older men: what they know, their beliefs, fears, habits, conceptions, and behaviors concerning their health, illness, medications, and treatments. Torres et al. (2008) reveal the importance of such exploration to understand and address the deeply rooted web of ideology, norms, and practices that influence health decision making and behavioral responses. Kruger et al. (2007) argue that professionals must ask elders questions about their functional and emotional health status. Health professionals should understand older men's "supportive environments" (Zanchetta, 2002, p. 294), comprising their families and their social and information networks. Without this baseline information about older men, health professionals will not be able to teach them appropriately, to enhance their understanding of diseases and treatment, to persuade them to follow medication and treatment regimes, or to prepare them to choose among treatment options (Kaszap & Drolet, 2009).

Transmitting information does not imply that its recipients agree with it and will immediately act upon it. New knowledge needs to be constructed. Knowledge construction means, therefore that, when new knowledge is offered, it needs to be discussed, even challenged, before it can be accepted and integrated in an individual's own existing knowledge system. Construction of health-related knowledge requires time, but taking this time will save time and money in the long run: time lost in repeated explanations, time and money lost in preventable hospitalization and preventable health deterioration. Moon (2011) explains that elder experience transformative learning with success but as a process which takes time and need support. Knowledge construction happens within relationships between older individuals and health professionals when professionals explore with elders their health backgrounds – their values, beliefs, fears, habits, attitudes, conceptions, and behaviors; and when professionals respect each patient's learning style: their individual ways of listening, asking questions and answering them. Knowledge construction also happens when explanations are meaningful (neither too technical nor childish) and use appropriate terminology, examples, or visual aids, such as photos and drawings. Concomitantly, lack of trust in relationships between health professionals and older individuals may jeopardize their engagement in teaching-learning initiatives, due their fear of disclosing personal information about their health problems (Kaszap & Drolet, 2009). Professionals need to find out about older men's misconceptions and false beliefs by asking questions about their health, illness, and treatment. By 'misconceptions', we mean erroneous explanations from erroneous understandings. By 'false beliefs', we mean beliefs based on superstitions and popular knowledge, not on scientific proof. All together, they are erroneous premises. These erroneous premises should be challenged and deconstructed prior to proposing new knowledge. Deconstructing knowledge means that professionals need to ask questions about an older man's conceptions or beliefs to be able to understand why the older man thinks the way he does. Where did he get that explanation? Then professionals need to start a dialog about both sides of the argument and give examples and explanations based on scientific knowledge. Professionals need to drive the discussion in a way that older men will adopt the scientific position because, when older people do not properly understand their disease and the needed treatments, when they are not adhering with their treatments or medication, they become severely ill and need to be hospitalized.

products that supposedly have miraculous effects on various diseases. Before delivering health information, health professionals should seek to understand the literacy backgrounds of older men: what they know, their beliefs, fears, habits, conceptions, and behaviors concerning their health, illness, medications, and treatments. Torres et al. (2008) reveal the importance of such exploration to understand and address the deeply rooted web of ideology, norms, and practices that influence health decision making and behavioral responses. Kruger et al. (2007) argue that professionals must ask elders questions about their functional and emotional health status. Health professionals should understand older men's "supportive environments" (Zanchetta, 2002, p. 294), comprising their families and their social and information networks. Without this baseline information about older men, health professionals will not be able to teach them appropriately, to enhance their understanding of diseases and treatment, to persuade them to follow medication and treatment regimes, or to prepare them to choose among

Transmitting information does not imply that its recipients agree with it and will immediately act upon it. New knowledge needs to be constructed. Knowledge construction means, therefore that, when new knowledge is offered, it needs to be discussed, even challenged, before it can be accepted and integrated in an individual's own existing knowledge system. Construction of health-related knowledge requires time, but taking this time will save time and money in the long run: time lost in repeated explanations, time and money lost in preventable hospitalization and preventable health deterioration. Moon (2011) explains that elder experience transformative learning with success but as a process which takes time and need support. Knowledge construction happens within relationships between older individuals and health professionals when professionals explore with elders their health backgrounds – their values, beliefs, fears, habits, attitudes, conceptions, and behaviors; and when professionals respect each patient's learning style: their individual ways of listening, asking questions and answering them. Knowledge construction also happens when explanations are meaningful (neither too technical nor childish) and use appropriate terminology, examples, or visual aids, such as photos and drawings. Concomitantly, lack of trust in relationships between health professionals and older individuals may jeopardize their engagement in teaching-learning initiatives, due their fear of disclosing personal information about their health problems (Kaszap & Drolet, 2009). Professionals need to find out about older men's misconceptions and false beliefs by asking questions about their health, illness, and treatment. By 'misconceptions', we mean erroneous explanations from erroneous understandings. By 'false beliefs', we mean beliefs based on superstitions and popular knowledge, not on scientific proof. All together, they are erroneous premises. These erroneous premises should be challenged and deconstructed prior to proposing new knowledge. Deconstructing knowledge means that professionals need to ask questions about an older man's conceptions or beliefs to be able to understand why the older man thinks the way he does. Where did he get that explanation? Then professionals need to start a dialog about both sides of the argument and give examples and explanations based on scientific knowledge. Professionals need to drive the discussion in a way that older men will adopt the scientific position because, when older people do not properly understand their disease and the needed treatments, when they are not adhering with their treatments or medication, they become severely ill

treatment options (Kaszap & Drolet, 2009).

and need to be hospitalized.
