PEER EDUCATION and salutogenesis with the method of “Salotti del BenEssere®”


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Submission Date: 2020-02-10
Review Date: 2020-02-24
Pubblication Date: 2020-03-09
Printed on: Volume 2, Issue I

Abstract

Abstract:

As part of the promotion of self-care and the culture of bio-psycho-social, a research path has been proposed - intervention on the perception of the bodily self in the relationship with the other and on the adoption of healthy lifestyles, aimed at university students of the Degree Course in Education Sciences, which used the educational strategy of “peer education” for the co-construction of motivational settings.
Peer education in study and training courses aim to experiment with embodied education, has enabled training and trans-training processes to be activated of the self-person and the i-Professional Educator, in which we started from the observation and assessment of kinetics to analyse the process cognitive impairment generated. It has been used to train peer educators on the methodology: I Salotti del Benessere®1 that includes a quality-quantitative evaluation process which allows you to detect the health demand of the peer group.
In addition, through “Empowerment psicocorporeo®” the method promotes, it was possible to activate a process self-assessment that has enabled students, future educators, to learning a trans-training mode to facilitate the dissemination of a culture of well-being.
The relapse of the educational path, of which in this pilot work we report the results, has been carried out by a team of educators and psychologists, that is from internal and external partners to the institution, and has previewed, besides the administration of tests, also the participating observation of the team and peer educators trained previously.

INTRODUCTION

As part of the promotion of health and the culture of bio-psycho-social well-being, a research path has been proposed – intervention on the perception of the bodily self in the relationship with the other and on the adoption of healthy lifestyles, addressed to students of the Degree Course in Sciences of Education (univ. Suor Orsola Benincasa), Chair of Pedagogy of Communication, coordinated by Dr. D’Ambrosio, whose first results in this pilot study.

The research was conducted through curricular laboratories on: “La Relazione con l’altro. I salotti del Benessere[1] and supervision interventions, in other extracurricular laboratories, on the participatory evaluation and implementation of Peer Education in University, held by Dr. Sara Diamare, U.O.C. Qualità e Umanizzazione of ASL Napoli 1 Centro[2].

The students of the formative paths taken into consideration by this study, have worked in parallel, sharing, but in different times and methodologies, the experimentation of the embodied education[1]  and the psychocorporeal self-evaluation.

Such educational intervention reflects on the need to train “care” professionals, such as training, education and health care professionals, who use embodied education practices and Empowerment psicocorporeo® to generate transformative learning processes, and to co-build learning settings and shared evaluation tools.

Having proposed such a training mode for future educators is the goal of open multidisciplinary health promotion spaces in various contexts (health facilities, schools, universities, etc.) to enable listening and identifying discomfort and needs acquisitions, as well as acquiring techniques to support and promote maintaining a healthy lifestyle, experiencing its effectiveness firsthand.

METHODOLOGY AND MATERIALS

The evaluation study presented here is part of an extensive research-intervention project for the co-construction of small communities that motivate the adoption of healthy lifestyles and spread among peers (“tra pari”) the concept of well-being as reciprocity, through bodily awareness and an expressive choreotherapy in harmony with the environment and in respect of the other.

The Peer-education in this context has been used because it is a didactic strategy that has found strong impetus in the 1990s especially in the school context, where students trained and coordinated by teachers, provide support to their peers in situations of risk and discomfort.

Underlying this educational technique is Bandura’s theory [2] of self-efficacy development and can result in a model of working with adolescents to develop real processes of autonomy and empowerment.

The design model is part of the community psychology and makes use of the theoretical-practical contributions of Lewin [3] research-action, social, cultural and community animation at the methodological level, involving the responsibility of each one for himself and the others, strengthening group work with the active involvement of all.

Peer-education fits on the horizon theoretical-practical care by the community (community that takes care of itself), rather than care in the community (presenting care community). In this sense, the community itself is active and configures as the subject and main actor of the project [4].

Following the accession of the Ministry of Public Education to the international project “Educazione tra pari[3] to prevent and reduce addiction and psychopathological deviance in schools (Directive 292 of 3/12/1999, art. 2) there has been a strong interest in this methodology by proposing at national and regional level Peer Education-based programs such as a research-intervention programme in health promotion and salutogenesis [5].

Antonowsky’s salutogenesis is also based on empowerment of subjects, as active participants of generative processes health care. It is aimed at promoting well-being through healthy lifestyles.

The salutogenesis [6] model I Salotti del Benessere®” used in the curricular laboratories referred to in this evaluation study represents a multi-centre space for the promotion of health and care for groups and communities, where a specialized team realizes a multidisciplinary program to promote health especially in the didactic or rehabilitative field, through techniques of psycho-corporeal awareness, in order to motivate the adoption of correct lifestyles.

This model, tested as good practice from the U.O.C. Qualità e Umanizzazione Asl Napoli 1 Centro, is born in Campania Region in 2009 with the Health Promoting Hospitals & Health Services Network (OMS) for the promotion of health between healthcare professionals, caregivers and patients, in a co-constructive and to activate body awareness processes and regain body awareness motivation to adopt healthy lifestyles for one’s own well-being.

The method it is also transferable in University contexts, as in this case, because it is easily adapts to the target to which it is aimed while preserving its structure basic information.

To allow a deep understanding of the contents, the elaboration of the experiences in transferable experiences in the operativity, and to motivate to the change, I Salotti del Benessere, for almost all of the time, develop health promotion topics through experiential workshops in a psychosomatic key.

The methodology, in fact, provides 5-10 meetings, during which 5 specific themes are dealt with called Keys, related to the health risk:

  1. Conscious Breath Key (associated with tobacco smoke deterrence);
  2. Relaxation Key, to facilitate stress management, focused on contraction/distension agitates;
  3. Nutrition Key, to reflect on the quality but also on the way of nourishment;
  4. Empowerment Key, marked on the psycho-corporeal strengthening (in which the method of the Creative Conscious Incarnate Aesthetic Experience is used);
  5. Movement and emotion Key, to promote the awareness of one’s body in the relationship with the other.

Each meeting also includes a verbal return on the experience in a circular setting and/or a final ritual symbolically linked to the theme of health education treated.

The tools used to evaluate the training course were:

• The Diade Card (Scheda Diade[1])

• Interview with healthy lifestyles

DIADE Card tab. rev. 3 Reading the motion: observation and self-assessment of the body movement, it is used to monitor perception of movement in the relational space of individual subjects. Is a card that analyzes the postural and expressive characteristics of the body and movement of a subject.  It, in a simplified formula for self-administration, is inspired Laban [7] movement analysis which is based on the detection of 8 categories action translated into 8 items.

  1. Chinesfera: the space of equilibrium experienced by the subject starting from his own corporeal centre of gravity;
  2. Centrality: motor impulse that comes from the body center, that is from the visceral zone;
  3. Structuring: movements with a defined shape contained in technical dishcloths, or studied and not spontaneous
  4. Rhythm: motor accord with the music, according to the times proposed by the conductor for the chosen exercise, or following the overall movement of the group;
  5. Coordination: harmony in the mode of execution of the gesture or in the finalized execution of an action;
  6. Flow: passage of motor energy from one point of the body to another with/without barriers/tonic-muscular blocks;
  7. Rigidity of motor control: overall tonic-muscular control level of the body in the presence of defensive contractures;
  8. Intensity: movements starting from the center of the body infuse pathos into the expression of the gesture.

In Diade Card rev. 3 the score is expressed on Scala Likert, so each of the 8 items described, varies potentially from 1 to 5. The categories examined concern elements indicative of gestures and quality of movement more sensitive to the detection of changes in relational aspect and are representative of the quality of non-verbal communication agitates in the report. Such a card, in fact, provides a subjective method of qualitative self-assessment of one’s movement in a relational context. The compilation should be preceded by a learning of the indicators used to allow the evaluation of the performance of dialogical mirroring. The administration was supported by a Dance Movement Therapy [8] module studied ad hoc: subjects were invited to observe their own movement and that perceived mirroring the other. The body experience of the mirroring of the movement of others has been the subject of discussion and comparison about the ability to observe and modulate the motor relationship mode, while the answers to the analytical items of the card were given from the evaluation of one’s movement in space.

  1. Interview Healthy Lifestyles elaborated on the notes of the PASSI 2005 project (Progress of Health Companies in Italy) National Institutes of Health. The interview aims to investigate lifestyles and habits of the subjects. It consists of two parts: the first, which includes 5 items whose score is expressed on 5-point Likert Scale, potentially ranging from 1 “for nothing” to 5 “very much”; The second part, on the other hand, consists of 9 questions which provide both answers structured as short open responses that investigate habits in terms of participants’ lifestyles.

STUDY OBJECTIVE

An integral part of the educational project was an orientation to the self-evaluation of the process and outcomes, in terms of effectiveness, with regard to the individual psycho-corporeal awareness and relational quality of the group.

The objective of the study was to investigate the effects of participation in the laboratory on I Salotti del Benessere® on the perception of quality of life related to health.

It was also decided whether the embodied methodology used had a positive impact on the quality of non-verbal communication of the participants and what differences emerge in the parameters examined between two groups compared: Experimental, with the method of I Salotti del Benessere® and control, made up of the students of the extracurricular laboratory.

As the participation in research by students was voluntary and within the time allowed by the laboratories, and not all students could be present on the test days, the result shall be considered as guidance for further research.

DISCUSSION AND RESULTS

Below are the results in terms of body and kinetic perception in the relationship with the other and lifestyles acquired by the group of students from the wellness salons workshop.

The following analysis was carried out on a sample of no. 25 women, on a total of 30 female students, aged between 21 and 34.

  1. DIADE Card tab. rev. 3 movement reading

Below are the values reached by the experimental group for each of the 8 items examined and the total ex ante compared to the values reached ex-post.

Non-parametric Test “Wilcoxon signed Ranks Test” was used for a statistical evaluation of the collected data.

From the psycho-corporeal evaluation carried out on the considered sample of n. 25 women/30 participants in the course, a positive increase of the total emerges and there is also a statistically significant improvement of the two dimensions: centrality and intensity.

Statistically significant data (<0.003 level) refer to the following items:

  • Centrality: statistically significant difference, equal to 0.001 [Asymp. (2-tailed)]
  • Intensity: statistically significant difference, equal to 0,002 [Asymp. (2-tailed)]
  • Total: Statistically significant difference of 0,001 [Asymp. (2-tailed)].

The other items investigated are not statistically significant.

Rank tests with Wilcoxon sign (Diade Card rev.3 experimental group)

Specifically, we could say that movements are perceived by the majority of subjects as more structured, but central and intense that is lived on a visceral level. It increases the capacity of each to expose oneself to a larger movement in space and is less inhibited the exploration of new horizons and perspectives. Increases the emotional intensity in the exploration of the relationship with the other which is less inhibited and more open to interaction.

To further confirm this, the observations of the participating students themselves and the Peer educators during the verbal feedback, the observation of the motor and relational behaviour by the teachers/tutors.

These data, which represent an improvement in the perception of the quality of movement of each individual in the group, express a process in the making, rather than a state of awareness reached by the students, who are thus trained to ‘reflect’ on their gestural and relational model in order to be able to join, in turn, as Peer educator to the next I Salotti del Benessere®.

  •  Interview on Healthy Lifestyles

Below are the values reached by the experimental group for the items examined and the total ex ante compared to the values reached ex post.

The evaluation of the sample (No. 20 women/30 participants) shows a general increase in all dimensions related to the perception of psycho-physical well-being.

In particular, the items that in the first part of the questionnaire concern breathing and psycho-physical relaxation vary positively.

In the following tab. n. 2 the values expressed by the individual items are examined:

Tab. 2
Graph 2

At the end of the activities, the subjects gained a greater awareness of their way of breathing, of their way of ‘perceiving the body from within’, or to feel and recognize the needs coming from it and at the same time an improvement of the values of the relaxation.

In the second part of the questionnaire, which investigates subjects’ lifestyles, some improvements in nutrition emerge. In particular, as can be seen from Graph 3, the portion of fruit consumed during a week has increased, on the other hand, the consumption of meat per week has decreased.

Decrease, even a little, also the quantity of cigarettes smoked per day, since it could well be agreed with the positive variation of the item “Breath” (Respiro): the subjects acquiring, a greater awareness of their way of breathing during the I Salotti del Benessere®, They were also aware of the need to reduce the number of cigarettes consumed daily to feel fit.

Graph 3 Fruit/vegetable portions and meat consumption

Rank tests with Wilcoxon sign (Interview on Healthy Lifestyles experimental group)

  1. Control Group

The other extracurricular laboratory “Art and Education for Social Welfare”, which also experimented with the methodology of embodied education, here used as a control group, provided for a greater number of meetings (n. 17) within 4 months with a participatory mode, but without the focus on the Empowerment psicocorporeo® and lifestyles typical of I Salotti del Benessere®.

In this second part of our study, we compare the results of the two groups in terms of body awareness in the relationship with the other through the results of the administration of the Diade Card tab. rev.3, also to this other group, in the same way as self-evaluation.

The sample considered of n. 20 women/40 participants in the course, shows a positive increase in the total of values and there is also a statistically significant improvement in the dimensions rhythm, intensity, rigidity.

Statistically significant data (Level 0.01) refer to the following items:

  • Rhythm: statistically significant difference, equal to 0,002 [Asymp. (2-tailed)]
  • Intensity: statistically significant difference, equal to 0,006 [Asymp. (2-tailed)]
  • Rigidity: statistically significant difference, equal to 0,006 [Asymp. (2-tailed)]
  • Total: Statistically significant difference, equal to 0,006 [Asymp. (2-tailed)]

The other items are not statistically significant.

In particular, we can affirm that globally also in this group, it improves the perception of its own movement in the relation with the other; the movements are perceived, by the majority of the subjects belonging to this second group, at the end of the extracurricular training course, more in harmony with the others and in motor harmony with the music; moreover, the overall level of tonic-muscular control of the body and the presence of defensive contractures decreases; increases the emotional intensity of the gesture in the exploration of the relationship with the other.

Rank tests with Wilcoxon sign (Diade Card rev.3 Control Group)

In comparing the results of the administration of the Diade Card Tab. Rev.3 between the experimental and control groups, an interesting data emerges concerning a difference in data significance between the experimental and control groups. In fact, the examination of the control group data gives a level of significance with a margin of error of less than 10%, while the results of the experimental group participating in the laboratory on I Salotti del Benessere® have a level of significance with margin of error of less than 3%. The significance of the figure that is higher for the group that participated in the I Salotti del Benessere® comforts us in continuing the research in the direction of associating embodied education with the mode of salutagenesis based on Empowerment psicocorporeo®.

CONCLUSION

From the descriptive data reported here, it emerges that the subjects who took part in the training experience in which the methodology of I Salotti del Benessere® was used, have modified some habits or behaviors at risk.

This change can also be seen as a consequence of the work of peer education in which students have actively participated.

Through the Art and Dance Movement Therapy (DMT), used as tools to experience the fundamental role that the body, movement and perceptual activity have for cognitive development has built a community of learning practice, made up of students, peer-tutors and reference adults, involved in a teaching-learning cascade process that has been carried on over the years.

The graphs presented confirm that the change has occurred on several fronts, both physically and mentally, affecting, among other things, some everyday behaviors such as diet, breathing modes and addiction to cigarette smoke.

In conclusion, the qualitative-quantitative evaluation integrated in the I Salotti del Benessere® method within a peer education program, allows to highlight the peer group’s health demand, using health indicators that can be monitored, and to verify the effectiveness of proposed health promotion actions through a process of psycho-corporeal empowerment that has allowed students, future educators, to learn a transformative mode to promote the dissemination of a well-being.

References

  1. [5]  Antonvsky, A. (1979). Health, stress, and coping. S. Francisco: Jossey-Bass,
  2. [2]   Bandura, A. (2000). Autoefficacia. Teoria e applicazioni. Trento: Erickson,
  3. [1]   D’Ambrosio M. (2016), Teatro come metodologia trasformativa, La scena educativa fatta ad arte. Tra ricerca e formazione, Cartografie pedagogiche, Napoli: Ed. Liguori,
  4. [8]   Diamare S., Pocetta G., Polito G. (2010). Empowerment psicocorporeo come strategia di BenEssere e prevenzione del burnout nei servizi di cura. Educazione Sanitaria e Promozione della Salute. n. 4/2010 pp. 390 -404,
  5. [6] Diamare, S. (2015). I Salotti del Benessere. Napoli: Poligrafia-F.lli Ariello Editori s.a.s.,
  6. [7]   Laban R. (1999). L’arte del movimento. Macerata: Ephemeria Editore.,
  7. [3] Lewin K. (2005), La Teoria, La Ricerca, L’Intervento. Bologna: Il Mulino,
  8. [4]   Pellai, A., Rinaldin, V., Tamborini, B. (2002). Educazione tra Pari: Manuale teorico-pratico di empowered peer-education, Trento: Erickson,

Notes

  • [1]The relationship with the other. The wellness salons
  • [2]Complex Operating Unit Quality and Humanization of Local Health Services Naples 1 Center
  • [3]Peer Education