SELECTING OR DEVELOPING

In Massachusetts, health education curricula and textbooks are chosen locally. Most school districts have established processes to review and select texts and curricula. Ideally, this process involves a team or work group that includes health education specialists, curriculum specialists, physical education and family/consumer sciences teachers, school nurses, school physicians, school counselors, school administrators, food service administrators, parents, and community representatives. The School Health Advisory Committee may also be used for this purpose (see Chapter 2). Including parents and community members on curriculum review teams is important to ensure that the curriculum addresses health topics of local concern and that it is consistent with community values.

By reviewing the entire scope and sequence of the curriculum under consideration, the team can ensure that essential knowledge and skills are addressed, that there are no gaps or unnecessary redundancies in topic coverage, and that skills and concepts introduced in earlier grades are reinforced in later grades.

Effective curricula share eight characteristics:

• They are research-based and theory driven;
• They include basic, accurate information that is developmentally appropriate;
• They use interactive, experiential activities that actively engage students;
• They provide students with opportunities to model and practice relevant social skills;
• They address social or media influences on behavior;
• They strengthen individual values and group norms that support health-enhancing behaviors;
• They are of sufficient duration to allow students to gain the needed knowledge and skills; and
• They include teacher training that enhances effectiveness. (Lohrmann & Wooley, 1998)

Although many professionally developed health education curricula are available, most are either not comprehensive or not fully and rigorously evaluated. Some of the former category target specific age groups (e.g., K-3, early adolescents) rather than all ages. The majority of the latter, those with strong evaluation support for their effectiveness in influencing student behavior, have focused on a few specific outcomes, rather than covering the full range of important health topics. Recently, for example, a number of curricula or school programs which are focused on healthy eating and physical activity (Gortmaker et al., 1999) and suicide prevention (Aseltine & DeMartino, 2004) have been evaluated and have shown evidence of effectiveness. A list of research-based curricula and programs with evidence of reducing behaviors leading to teen pregnancy and sexually-transmitted disease is available from Advocates for Youth (2003). The U.S. Department of Education (2002) has published a list of exemplary and promising school programs with evidence of reducing violent behavior and substance use.

It is possible to find comprehensive school health education curricula with evaluation results supporting at least some objectives; four are listed at the end of this chapter under Resources: General Health Education Curricula. However, a school district may find that no single evaluated K-12 curriculum meets its needs and may decide to develop its own curriculum, to use different curricula at different grade levels, or to supplement topic-specific curricula with lessons from other sources. The district curriculum director and other school and community professionals who have expertise in health content and/or curriculum development should be key participants in such efforts.

In the future, the number of comprehensive, research-based programs is likely to increase. As availability increases, so will the expectation that schools will use programs and curricula that have been carefully evaluated. At present, the CDC-developed Health Education Curriculum Analysis Tool (HECAT) sets useful guidelines for schools or districts that need to select, review, or develop a school health education curriculum. In addition to step-by-step instructions for bringing together a curriculum review team, the HECAT also provides scoring sheets for team members to use in rating the extent of topic coverage and the depth of student skills practice. CDC has also developed a similar tool, called the PECAT, to assist with evaluation of physical education curricula. It has also provided the Consumer Guide to Health Education Curricula, an interactive, online program, based on the HECAT, which contains expert analyses of critical components of health education curricula. For more information about these tools, see CDC’s Division of Adolescent and School Health.