Beyond health knowledge and behavioural skills: Reimagining health education as autonomy development

Abstract

Purpose:

This discussion paper critically examines the underlying assumptions of a range of conventional health education theories. It proposes a fundamental shift towards a self-directed learning (SDL) approach that reconceptualises health education as autonomy development rather than behaviour modification.

Methods:

We conducted a comparative analysis of six influential health behaviour theories, including the Health Belief Model, the Transtheoretical Model, Social Cognitive Theory, the Theory of Planned Behaviour, the Theory of Reasoned Action and the Information-Motivation-Behavioural-Skills Model. We examined their key components, core assumptions and prescribed educator roles. We then mapped SDL principles onto the World Health Organization’s (WHO) seven core health educator responsibilities to operationalise these as an alternative paradigm.

Findings:

In today’s digital landscape where health information is abundant yet of varying quality, conventional health education theories are limited in addressing contemporary needs. This paper examines how professional health educators can facilitate comprehensive autonomy development through SDL approaches. The SDL framework encompasses not only critical thinking skills but also the full cycle of autonomous learning processes, including self-assessment, goal-setting, planning, implementation, monitoring, reflection and adaptive problem-solving. This systematic approach to developing learner autonomy through professional health education practice fills an important gap in the literature and aims to develop individuals capable of independently navigating complex health landscapes throughout their lifespans.

Conclusions:

The SDL approach transforms health education from behaviour change to autonomy development, requiring health educators to shift from being authoritative experts to learning facilitators. This transformation suggests new directions for professional training, educational materials, evaluation strategies, and interdisciplinary collaboration.