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CDC's School Health Education Resources (SHER)
Characteristics of an Effective Health Education Curriculum
Today’s state–of–the–art health education curricula reflect the
growing body of research that emphasizes teaching functional health
information (essential concepts); shaping personal values that support
healthy behaviors; shaping group norms that value a healthy lifestyle;
and developing the essential health skills necessary to adopt, practice,
and maintain health–enhancing behaviors. Less effective curricula often
overemphasize teaching scientific facts and increasing student
knowledge.
Reviews of effective programs and curricula and input from experts in
the field of health education have identified the following
characteristics of an effective health education curriculum1-12:
- Focuses on clear health goals and related behavioral outcomes.
Curricula have clear health-related goals and behavioral outcomes that
are directly related to these goals. Instructional strategies and
learning experiences are directly related to the behavioral outcomes.
- Is research–based and theory-driven. Instructional strategies and
learning experiences build on theoretical approaches (for example, social
cognitive theory and social inoculation theory) that have effectively influenced
health-related behaviors among youth. The most promising curricula go beyond the
cognitive level and address health determinants, social factors, attitudes,
values, norms, and skills shown to influence specific health–related behaviors.
- Addresses individual values and group norms that support health–enhancing
behaviors. Instructional strategies and learning experiences help students
accurately assess the level of risk-taking behavior among their peers (for
example, how many of their peers use illegal drugs), correct misperceptions of
peer and social norms, and reinforce health-enhancing values and beliefs.
- Focuses on increasing personal perceptions of risk and harmfulness of
engaging in specific health risk behaviors and reinforcing protective factors.
Curricula provide opportunities for students to assess their vulnerability to
health problems, actual risk of engaging in harmful health behaviors, and
exposure to unhealthy situations. Curricula also provide opportunities for
students to validate health enhancing beliefs, intentions, and behaviors.
- Addresses social pressures and influences. Curricula provide
opportunities for students to address personal and social pressures to engage in
risky behaviors, such as media influence, peer pressure, and social barriers.
- Builds personal competence, social competence, and self efficacy by
addressing skills. Curricula build essential skills including
communication, refusal, assessing accuracy of information, decision–making,
planning and goal–setting, self–control, and self–management, that enable
students to build personal confidence and ability to deal with social pressures
and avoid or reduce risk behaviors. For each skill, students are guided through
a series of developmental steps:
- Discussing the importance of the skill, its relevance, and
relationship to other learned skills.
- Presenting steps for developing the skill.
- Modeling the skill.
- Practicing and rehearsing the skill using real–life scenarios.
- Providing feedback and reinforcement.
- Provides functional health knowledge that is basic, accurate,
and directly contributes to health–promoting decisions and behaviors.
Curricula provide accurate, reliable, and credible information for
usable purposes so that students can assess risk, correct misperceptions about
social norms, identify ways to avoid or minimize risky situations, examine
internal and external influences, make behaviorally–relevant decisions, and
build personal and social competence. A curriculum that provides information for
the sole purpose of improving knowledge of factual information is incomplete and
inadequate.
- Uses strategies designed to personalize information and engage
students. Curricula include instructional strategies and learning experiences
that are
student–centered, interactive, and experiential (for example, group discussions,
cooperative learning, problem solving, role playing, and peer–led activities).
Learning experiences correspond with students’ cognitive and emotional
development, help them personalize information, and maintain their interest and
motivation while accommodating diverse capabilities and learning styles.
Instructional strategies and learning experiences include methods for
- Addressing key health–related concepts.
- Encouraging creative expression.
- Sharing personal thoughts, feelings, and opinions.
- Developing critical thinking skills.
- Provides age–appropriate and developmentally–appropriate
information, learning strategies, teaching methods, and materials.
Curricula address students’ needs, interests, concerns, developmental
and emotional maturity levels, experiences, and current knowledge and skill
levels. Learning is relevant and applicable to students’ daily lives. Concepts
and skills are covered in a logical sequence.
- Incorporates learning strategies, teaching methods, and materials
that are culturally inclusive. Curricular materials are free of
culturally biased information, but also include information, activities, and
examples that are inclusive of diverse cultures and lifestyles (such as gender,
race, ethnicity, religion, age, physical/mental ability, and appearance).
Strategies promote values, attitudes, and behaviors that acknowledge the
cultural diversity of students; optimize relevance to students from multiple
cultures in the school community; strengthen students’ skills necessary to
engage in intercultural interactions; and build on the cultural resources of
families and communities.
- Provides adequate time for instruction and learning.
Curricula provide enough time to promote understanding of key health
concepts and practice skills. Affecting change requires an intensive and
sustained effort. Short-term or “one shot” curricula, such as a few hours at one
grade level, are generally insufficient to support the adoption and maintenance
of healthy behaviors.
- Provides opportunities to reinforce skills and positive health
behaviors. Curricula build on previously learned concepts and skills
and provide opportunities to reinforce health–promoting skills across health
content areas and grade levels. This could include incorporating more than one
practice application of a skill, adding "skill booster” sessions at subsequent
grade levels, or integrating skill application opportunities in other academic
areas. Curricula that address age-appropriate determinants of behavior across
grade levels and reinforce and build on learning are more likely to achieve
longer–lasting results.
- Provides opportunities to make positive connections with
influential others. Curricula link students to other influential
persons who affirm and reinforce health–promoting norms, beliefs, and behaviors.
Instructional strategies build on protective factors that promote healthy
behaviors and enable students to avoid or reduce health risk behaviors by
engaging peers, parents, families, and other positive adult role models in
student learning.
- Includes teacher information and plans for professional
development and training that enhance effectiveness of instruction and
student learning. Curricula are implemented by teachers who have a
personal interest in promoting positive health behaviors, believe in what they
are teaching, are knowledgeable about the curriculum content, and are
comfortable and skilled in implementing expected instructional strategies.
Ongoing professional development and training is critical for helping teachers
implement a new curriculum or implement strategies that require new skills in
teaching or assessment.
References
- Botvin GJ, Botvin EM, Ruchlin H.
School-Based Approaches to Drug
Abuse Prevention: Evidence for Effectiveness and Suggestions for
Determining Cost-Effectiveness [pdf 85K]. In: Bukoski WJ, editor.
Cost-Benefit/Cost-Effectiveness Research of Drug Abuse Prevention:
Implications for Programming and Policy. NIDA Research Monograph,
Washington, DC: U.S. Department of Health and Human Services,
1998;176:59–82.
- Contento I, Balch GI, Bronner YL. Nutrition education for school-aged
children. Journal of Nutrition Education 1995;27(6):298–311.
- Eisen M, Pallitto C, Bradner C, Bolshun N.
Teen Risk-Taking:
Promising Prevention Programs and Approaches*. Washington, DC:
Urban Institute; 2000.
- Gottfredson DC. School-Based Crime Prevention. In: Sherman LW,
Gottfredson D, MacKenzie D, Eck J, Reuter P, Bushway S, editors. Preventing Crime: What Works, What Doesn’t, What’s Promising* [pdf 100K].
National Institute of Justice; 1998.
- Kirby D. Emerging Answers: Research Findings on
Programs to Reduce
Teen Pregnancy. Washington, DC: National Campaign to Prevent Teen
Pregnancy; 2001.
- Lohrmann DK, Wooley SF. Comprehensive School Health Education. In:
Marx E, Wooley S, editors. Health Is Academic: A Guide to Coordinated
School Health Programs. New York: Teachers College Press; 1998:43–45.
- Lytle L, Achterberg C. Changing the diet of America’s children:
What
works and why? Journal of Nutrition Education 1995;27(5):250–60.
- Nation M, Crusto C, Wandersman A, Kumpfer KL, Seybolt D,
Morrissey-Kane, E, Davino K. What works: Principles of effective
prevention programs. American Psychologist 2003;58(6/7):449–456.
- Stone EJ, McKenzie TL, Welk GJ, Booth ML. Effects of physical
activity interventions in youth. Review and synthesis. American Journal
of Preventive Medicine 1998;15(4):298–315.
- Sussman, S. Risk factors for and prevention of
tobacco use. Review. Pediatric Blood and Cancer 2005;44:614–619.
- Tobler NS, Stratton HH. Effectiveness of
school-based drug prevention programs: a meta-analysis of the
research. Journal of Primary Prevention 1997;18(1):71–128.
- Weed SE, Ericksen I. A Model for Influencing Adolescent
Sexual
Behavior. Salt Lake City, UT: Institute for Research and Evaluation;
2005. Unpublished manuscript.
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