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Teenage Health Teaching Modules

Ages 11-18

Rating: Level 3


Teenage Health Teaching Modules (THTM) is a comprehensive school health curriculum for grades 6 to 12. THTM has three primary components: 1) health tasks of adolescence, 2) health content areas, and 3) essential health skills and themes. Health tasks incorporated in THTM include having friends and building positive relationships, recognizing feelings and managing them in positive ways, and protecting oneself and others from use of tobacco, alcohol, and other drugs. Health content areas include personal health; disease prevention and control; nutrition; alcohol, tobacco, and other drug use; injury and violence prevention; mental and emotional health; consumer health; healthy relationships; community and environmental health; and family life. Examples of health skills addressed in THTM are risk assessment, self-assessment, communication, decision-making, goal setting, health advocacy, and healthy self-management. THTM also reinforces themes of protection, responsibility, interdependence, and respect throughout the curriculum. One of the modules—Aggressors, Victims, and Bystanders—concentrates on middle school violence prevention.

Materials are organized by developmentally based health tasks of concern to adolescents, rather than by content area. THTM is composed of a series of modules, each of which consists of a teacher’s guide with a detailed framework for conducting classroom activities and handouts to be duplicated for student use. Teachers are encouraged to add their own supplementary activities, materials, and ideas. The program does not require a particular implementation sequence, use of a minimum number of modules, or prior training of teachers. All modules are intended to develop five skills: self-assessment, communication, decision-making, health advocacy, and healthy self-management.


The evaluation employed a quasi-experimental pretest–posttest control group design to assess THTM’s effectiveness in an experimental setting, in which rigorous control was exercised over exposure to teacher training and choice of curriculum materials (modules) used and a naturalistic setting involving users who had made the independent decision to adopt THTM before the study, with less rigorous control of the teacher training and choice of curriculum materials.

Classes were selected differently for the two types of schools. In experimental schools, one academic subject area was generally selected by school administrators as the appropriate “home” for THTM, and one class section was selected randomly as the treatment group from all class sections at the designated grade level. Likewise, a second academic subject was selected as an appropriate control, and one class section was selected randomly as the control group from available class sections. Control sections were required to contain limited or no health content.

In naturalistic settings, since THTM was already in place, one THTM group was selected randomly from among sections scheduled to receive the selected THTM modules during the observation period. One naturalistic control group was selected randomly from a different academic subject. Again, control sections contained little or no health content.

An attempt was made to select THTM and control classrooms at the same grade level from different academic subjects with mutually exclusive enrollments. In practice, two conditions made such selection difficult: 1) when small schools had only one class section at a grade level, and 2) when larger schools elected to require THTM of all students at the grade level. Under both conditions, the control group was selected randomly at the next higher grade level.

The evaluation study used five data collection instruments. One instrument was administered to students, and teachers completed another instrument. Investigators conducted the evaluation in 149 junior high/middle schools and senior high schools in seven States. The final sample included 4,806 students with matched pretest and posttest questionnaires (2,530 who received THTM and 2,276 controls).


THTM produced positive effects on knowledge, attitudes, practices, and some self-reports of behaviors in selected subgroups of students. Junior high/middle school students and senior high school students who were exposed to THTM exhibited more knowledge about health issues in both experimental and naturalistic classrooms. Senior high school students in both experimental and naturalistic settings and junior high/middle school students in naturalistic schools showed desired attitudinal changes.

Exposure to THTM also resulted in several important self-reported behavioral changes. For example, students in senior high experimental and naturalistic schools reported a reduction in drug use and cigarette smoking. Self-reported levels of alcohol consumption also were reduced among senior high school students in naturalistic schools. THTM had no discernible effects on the self-reported behaviors of junior high/middle school students.

The evaluation also found that teachers who received THTM training before they used the curriculum felt more prepared to teach THTM, were less apt to modify the curriculum, and achieved more positive effects on student knowledge (and, at the senior high school level, on attitudes) than teachers who did not receive such training. Fidelity (tendency to implement the curriculum without modification) and proficiency (adaptation of the curriculum to meet student needs) were related independently to various teacher characteristics and to selected students outcomes.

Risk Factors


  • Cognitive and neurological deficits/Low intelligence quotient/Hyperactivity
  • Early sexual involvement
  • Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use
  • Mental disorder/Mental health problem/Conduct disorder
  • Poor refusal skills
  • Victimization and exposure to violence


  • Family management problems/Poor parental supervision and/or monitoring
  • Family violence
  • Pattern of high family conflict
  • Poor family attachment/Bonding


  • Negative attitude toward school/Low bonding/Low school attachment/Commitment to school


  • Availability of alcohol and other drugs
  • Social and physical disorder/Disorganized neighborhood


  • Peer alcohol, tobacco, and/or other drug use
  • Peer rejection

Protective Factors


  • Healthy / Conventional beliefs and clear standards
  • Positive / Resilient temperament
  • Self-efficacy
  • Social competencies and problem-solving skills


  • Good relationships with parents / Bonding or attachment to family


  • Opportunities for prosocial school involvement
  • Student bonding (attachment to teachers, belief, commitment)


  • Clear social norms / Policies with sanctions for violations and rewards for compliance


  • Good relationships with peers


  • SAMHSA: Model Programs
  • Department of Education


Errecart, Michael T., Herbert J. Walberg, James G. Ross, Robert S. Gold, John L. Fiedler, and Lloyd J. Kolbe. 1991. “Effectiveness of Teenage Health Teaching Modules.” Journal of School Health 61(1):26–30.

Gold, Robert S., Guy S. Parcel, Herbert J. Walberg, Russell V. Luepker, Barry Portnoy, and Elaine J. Stone. 1991. “Summary and Conclusions of the THTM Evaluation: The Expert Work Group Perspective.” Journal of School Health 61(1):39–42.

Nelson, Gary D., S. Cross Floy, and Lloyd J. Kolbe. 1991. “Teenage Health Teaching Modules Evaluation.” Journal of School Health 61(1):19.

Parcel, Guy S., James G. Ross, Alison T. Lavin, Barry Portnoy, Gary D. Nelson, and Franklin Winters. 1991. “Enhancing Implementation of the Teenage Health Teaching Modules.” Journal of School Health 61(1):35–38.

Ross, James G., Russell V. Luepker, Gary D. Nelson, Pedro Saavedra, and Betty M. Hubbard. 1991. “Teenage Health Teaching Modules: Impact of Teacher Training on Implementation and Student Outcomes.” Journal of School Health 61(1):31–34.


Erica Macheca
Education Development Center, Inc.
55 Chapel Street
Newton, MA 02458
Phone: (800) 225-4276
Fax: (617) 224-3436
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