Virginia AHPERD_SpringSummer2026

National Health Education Standards (Joint Committee on National Health Education Standards, 2007; SHAPE Amer ica, 2024) align with these highlighted philosophies such as Standard 1 functional health information (cognitive based philosophy), Standard 5 decision-making process (decision-making philosophy), Standard 7 practices and behaviors to support health (behavior change philosophy), Standard 8 advocacy (social change philosophy). There are numerous ways to begin the process of de veloping one’s own health education philosophy. For in stance, Gambescia (2007) discussed how one could align with the Roman style of philosophizing by using an eclec tic approach and shape the philosophy around what makes sense to the individual and then modify it based on person al preference. This can be achieved by blending and pri oritizing the previously cited philosophies with different combinations that may present themselves based on per sonal preference. For example, those attempting to change unhealthy behavior could use a skill-based approach and thus the decision-making and behavior change combina tion would logically fit together (Kolbe et al., 1982). Another avenue when considering a philosophy may be to start with cognitive-based to establish a functional knowledge foundation and then determine if the health educator should influence behavior according to science (behavior change) or if the individual should make deci sions that are best for them (freeing/functioning). Take note how decision-making skills can fit within the latter part of both philosophical approaches and thus a blend of cognitive-based/decision-making/behavior change, or cognitive-based/decision-making/freeing/functioning would logically fit together. If the goal shifts to bringing about positive change at the population or community lev els, then social change might be the dominate philosophy with a blended approach. As with many aspects in life, cir cumstances, age, experience, environment, and numer ous other factors can shift one’s view and priorities and thus one’s philosophy might evolve and change over time. The health educator may also consider the role of gov ernment laws, policies, and procedures and the impact on public health. For instance, seatbelt laws have reduced injuries and mortality during motor vehicle accidents (United States Department of Transportation, 2024) and campaigns to improve hygiene and disease prevention from basic measures such as hand washing have also been successful at saving lives (CDC, 2024). In accordance with social change, macro level advocacy and working with gov ernment officials may be the direction the health educator is compelled to take. Yet, for decades, behavior change has been a major goal of health education and promoted by many in the field such as Hochbaum (1981). However, for others, the essence of health promotion and for positive health outcomes to occur, an individual needs a significant amount of control over the decisions and conditions they experience (Anderson & Ronson, 2005). This would sug

gest that a freeing/functioning driven philosophy may be the right approach. Suggestions for Today’s Health Educator When investigating health-related issues to teach pre vention methods to students, cultural practices should be examined and accounted for since they are often linked with many behaviors correlated with health. For instance, most cases of morbidity and mortality in the USA are pre ventable and related to nutrition with significant evidence suggesting the true cause of these diseases and disability are our diet (Campbell & Campbell, 2016; Campbell, 2026; Greger, 2016). The USA consists of a very multi-ethnic, di verse, multi-racial population with numerous cultures be ing represented. The health educator should understand and relate to their students on an individual level to ascer tain their cultural identity and practices. Health-related autonomy is a state of making an in formed self-governing decision. Individual autonomy should be considered when teaching health education due to the potential positive impact on quality of life. For in stance, respecting and promoting autonomy when work ing with individuals with mental health conditions can improve self-esteem, recovery, confidence, and sustained health (World Health Organization, 2022). Yet, there are different forms of autonomy to consider such as full auton omy overall health-related decisions from start to finish or presenting healthy strategies and allowing for autonomy based on the available choices. Other variations include autonomy on the process but limiting the decision-making options to a list from which to choose. There are an endless list of health-related situations and approaches the health educator grapples with when de termining their philosophical approach. There are always pros and cons, along with limitations regarding any phi losophy and it is in the health educators’ interest to always assess the population they are working to ensure compat ibility. With a goal of allowing for some form of personal choice and sustaining positive health that is driven by sci ence and data, a health education philosophy for navigat ing today’s health-related issues could be categorized as the following: Independent Autonomous Behavior Change Philosophy Regarding sustainability, numerous individuals in various fields have discussed the power of intrinsic motivation (Deci, 1971; Falk, 2023; Pink, 2009). When attempting to maintain health-enhancing behaviors that could lead to a new positive lifestyle practice, the health educator should consider their role with incorporating an intrinsic, instead of an extrinsic approach. Aligned with intrinsic motivation is choice and empowerment when an individual desires to engage in a decision-making process due to self-inter est. To bridge a behavior-change methodology in which the health educator defines healthy behavior with a free-

4 • Virginia AHPERD • SPRING/SUMMER 2026