Chadwick Court, 15 Hatfields, London, SE1 8DJ Telephone: 020 7928 6006The CIEH is a registered charity Incorporated by Royal Charter (No. NG1 4BU.AbstractThe focus of this paper is an approach to help student environmental health officers develop skills in the arena of health promotion. The students are required to concentrate on student health needs and plan, run and evaluate a health promotion campaign.
This paper will explain the development of student skills within this area and provide an evaluation of student feedback related to the campaigns that ran over 2 separate years (n=60).
Results indicate that students find this to be a valuable  learning tool and they value the skills developed in addition to enjoying the process.
Within this framework the role of local authorities is being recognised as one of the partners in assisting the promotion of health at a local level. It is therefore essential that professionals in this setting have a clear understanding of the techniques involved in health promotion and an ability to evaluate their effectiveness when undertaking this work.Environmental Health comprises of those aspects of human health, including quality of life, that are determined by chemical, physical, biological, social and psychosocial factors in the  environment.
It also refers to the theory and practice of assessing, correcting and preventing those factors in the environment that can potentially affect adversely the health of present and future generations (MacArthur & Bonnefoy, 1997). Whilst much of the work undertaken is a statutory function in the areas of food safety, health and safety, environmental protection and housing it is often the case that they are the front line service for issues threatening people’s health.
Education and promotion are part of their day to day activities and yet there is a limited amount of training in these fields. The development of health promotion skills is essential if local authorities are to become involved in true partnerships with health authorities. Environmental Health Officers (EHO) are very used to thinking laterally, working across disciplines and to seeing the wider picture in relation to health issues. In order to do their work within the community they need to build alliances and partnerships with other health professionals and agencies. Health Promotion therefore underpins the work of the EHO although unfortunately since it is a non-statutory function this may well affect the position of this activity. Saving Lives, Our Healthier Nation (Department of Health, 1999) has recognised the value of the role of local authorities working in partnership with other key health providers and the community and the establishment of Health Action Zones to target health inequalities focuses on these links.Developing Transferable Professional Skills Within The Undergraduate Qualifying Environmental Health DegreeThe approach used to develop effective professional officers within the Undergraduate programme at Nottingham Trent University places problem-solving and transferable skill development as a central element within a reflective practitioner model of learning and professional development (Moon, 1999). Specific modules at each and every academic level are used as the main but not sole focus for this development. This approach recognises the idea of becoming competent in performing specific tasks as being a precursor to the production of ‘graduateness’ and capability, but that more is required to fulfil this task. Thus it identifies the crucial difference between training and education and accords with the model of professional development from novice to expert as researched by Dreyfus and Dreyfus (1986), cited in Eraut M (1994). They must be carefully selected to allow the individuals’, and groups in which they are placed, to demonstrate capability. Care has to be taken to avoid assessments that require a demonstration of competence in relation to the environmental health subjects and pure knowledge. Health Promotion features as a subject when introducing health and public health at the start of the course. The subject is introduced through the consideration and development of a model for health that embraces the range of factors that influence health and wellbeing, grouped according to the areas in which they operate in relation to the health of the individual (Dahlgren and Whitehead (1991)). Health Promotion is then developed into a module at final year level utilising an overarching approach to achieving environmental health objectives and to question routine professional behaviour in terms of the focus for environmental health work generally. Within the level 3 module, over a period of three months, the students are required, in-groups, to identify a student health need and then plan, run and evaluate a health promotion campaign within the university campus, too meet the need identified. In the past students have identified various health needs within the student population including sexual health, mental health, drug awareness and body art.

The need identified may be gained from experiences as a student but they are also encouraged to use epidemiological evidence to support their assessment.
The students then plan the area under consideration gathering data and information from various sources. The health promotion campaign is run at the city site students union over a day and the students carry out a shortterm evaluation of the event. Methods used by students to promote health have been many and varied included information leaflets, display material (posters and “mock-ups”), participative competitions, demonstrations and video’s. The results of the campaign are presented to an invited audience and a written evaluation report prepared. Both the report and presentation elements form part of the assessment for the module.MethodsIn order to evaluate the module an investigation was carried out to assess the students’ attitude towards the health promotion module and the use of the health promotion campaign assignment in developing their transferable skills.
Two consecutive final year cohorts of the BSc (Hons) Environmental Health from the years 1999 and 2000 were involved.
The research focused on the students’ evaluation of the health promotion module as a whole but particular emphasis was placed on the campaign that the students had been involved with.
It was decided that a mixture of quantitative and qualitative data was the best approach in order to gain a range of information for the study. The most appropriate study design was a self-completed questionnaire as it enabled assessment of a wide range of information at relatively low cost and retained anonymity in order to encourage honest feedback.The questionnaire was based on a standard departmental questionnaire that has been used successfully across a range of courses over the past few years. A total of 21 statements were made using a Likert scale with a scale of 1-5 where 1 was strongly agree and 5 strongly disagree with 3 being neutral. The initial 15 questions were standard questions that made various statements concerning the module as a whole. This required the students to provide feedback on the taught elements as well as the student led seminar exercises.
The questions sought to identify the level of enjoyment, the relationship to skill development and levels of confidence. The second part of the questionnaire was based on open questions and requested that the students made comments concerning the elements they felt most and least valuable in relation to the campaign. Finally the students were encouraged to make free comment concerning the module.Piloting had been carried out with the 1998 cohort of students and no difficulties were identified in responses. Due to the study design adopted it was decided to survey all those present following the completion of the campaign. Analysis was carried out by hand.ResultsIn the 1999 cohort there were a total of 40 students. Of these 85 percent had worked during their third year in a local authority environmental health department and 15 percent had not. This compared to a smaller cohort of 29 students during the year 2000, all of whom had undertaken a placement period during their third year. A response rate of 95 percent (n=38) was obtained from the 1999 cohort and 76 percent (n=22) from the 2000 cohort.Firstly the students were asked whether they had enjoyed participating in the health promotion campaign. In both years it was pleasing to note that the majority of students agreed or strongly agreed with the statement with over 85 percent (n=53) of students in both years supporting this view.
Secondly the students were asked whether the exercise had improved their confidence in planning, running and evaluating such a campaign. Again the results were high with over 90 percent (n=55) who agreed or strongly agreed with this statement.

Thirdly the students were asked if the campaign had improved their planning and organisational skills. Enquiries were then made to find whether the campaign had provided the students with the skills to evaluate a health promotion initiative as indicated in Figure 2.
Results from this question were a little disappointing in 1999 as just over half of the group agreed or strongly agreed with the statement that it had provided them with evaluation skills. As a result of this analysis the  theoretical input into evaluating health promotion was altered during the taught element of the course for the year 2000 cohort.
The actual health needs that the students had identified were utilised to provide examples of evaluation and the 2000 cohort statistics demonstrate an improvement in this area with 77 percent (n=17) of the students agreeing or strongly agreeing with the statement. Those contacted included health professionals from outside of the University, health professionals providing services to the students and staff within the University and Student Support Services. Figure 3 indicates that when questioned about their confidence in the identification of a range of resources and partners, 85 percent (n=51) of both cohorts felt more confident in this work. Finally fewer students saw the skills developed as linking across all areas of environmental health, however it may take more experience for the students to establish these wider integrating links.In addition to the questions above, the students were asked to comment on factors they believed were most and least valuable in relation to the health promotion campaign.
Feedback from this section demonstrated that students were very positive about the benefits of teamwork, communication and the improved understanding of the process. In order to demonstrate the positive aspects one student elaborated that “Organisational factors were the most valuable. The experience of planning and implementing a campaign will be very useful in the future” (Student 2000). On a negative note the lack of time for the actual campaign and the limited time period for evaluation were commented on including “It would have been better if more time was allocated post campaign in order to conduct a more thorough evaluation” (Student 1999).DiscussionThe development of effective professional officers places problem-solving and transferable skills as a central element and therefore the approach to health promotion assists in this process. In addition to this the health promotion module develops graduateness.The health promotion campaign provides a form of assessment that places the students at the centre of the activity. The students themselves are an important resource which can be utilised by the health promoting university whilst at the same time nurturing and developing the key transferable skills within the health promotion professionals of the future. This theoretical input and the practical experience of carrying out such an assessment provides the students with a skill to take forward into their future career which will also benefit their employers.Feedback from across the university, the professionals and agencies who have been involved and successive cohorts of participants have all commented on the value of such work both practically and professionally. The results indicate that most students found that various skills had been developed during the process of completing the campaign.
Utilising the feedback form also assisted in the reflection of the lecturing team as the results from the1999 cohort indicated that the students were not too confident in evaluation skills therefore the theoretical input was altered for the year 2000 cohort.The limitations identified related to the short-term nature of the campaign, evaluation focuses only on the immediate impact of a particular campaign on the day.
There may be merit in utilising campaign ideas year on year, and requiring students to further develop previously used campaigns.ConclusionWhilst the development of ‘real’ skills in actually undertaking health promotion work is crucial, students need to understand that health promotion is about more than this. The real challenge is to encourage a greater health promotion focus in the environmental health profession.Finally valuable bridges have also been built between students and those who provide a range of services for them within the University. It is hoped that these links will be further developed through involving health care providers and support services formally at an earlier stage in the planning of the campaigns.AcknowledgementsWe would like to extend our thanks to the students who have participated in these campaigns with such great enthusiasm.
Also the Students Union Welfare Officers over the years have provided space and support for the student group.ReferencesAnderson, C.

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