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Characteristics of Effective Health Curricula
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Characteristics of Effective Health Curricula



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  • 4. The Centers for Disease Control and Prevention, Division of Adolescentand School Health (CDC-DASH), has examined a synthesis ofprofessional literature to determine the common characteristics ofeffective health education curricula. Reviews by CDC-DASH of effectiveprograms and curricula, along with input from experts in the field ofhealth education, have identified 14 characteristics for effective healtheducation curricula that positively influence students’ health practices andbehaviors. This week we will examine those characteristics of effectivehealth education curricula. 4
  • 5. This has been a huge change in my thinking and this can really informed and guidedmy teaching. If we believe that our health education curriculum should changebehavior than we need to start with the specific behaviors that we want to change.If you think backwards design the ultimate standards or goal is to either reduce orprevent specific behaviors or improve others. For example, if we look at a curriculumon nutrition education are the lessons focused on increasing fruits and vegetableconsumption or decreasing foods with little or no nutritional value or does thecurriculum just teaching about the food plate?When I was teaching I spent a lot of time on activities that were fun and engaging forstudents but they really had little focus on any specific behavior. Only teaching aboutthe food plate for example, I’m not saying that you should not teach about the foodplate but I am encouraging you to think specifically about the behaviors you are tryingto change or maintain. After the basics of the food pyramid focusing on building skillsto advocate or communicate the need for more fruits and vegetables or setting goalsaround healthy eating behaviors might have been a better us of my time.If you are looking at tobacco prevention what are the specific behaviors that you aretrying to prevent, for some students it would be for them to quit smoking but for most itwould be prevent them from starting or to at least delay onset of use. 5
  • 6. Is the curriculum research based or theory driven? Can you clearly identify the theorythat drives the curriculum. Can you link your lessons and activities back to a behaviortheory such Health Behavior Model or at least a set of key constructs from BehaviorTheory does it focus on changing attitudes about perceived risks and rewards, does itfocus on the perceived social norms? Last semester you had the opportunity toexamine these behavior change theories and begin to examine how they can helpinform curriculum and teaching.Research based in another factor to consider, the gold standard is random controltrials (RCT) studies with replication. There are a number of websites that haveattempted to identify research based curricula, for example www.findyouthinfo.gov,and the blueprints for violence prevention http://www.colorado.edu/cspv/blueprints/ aretwo organizations that have identified research based programs for example Life SkillsTraining, Project Alert, Towards No Tobacco, and Towards No Drug Abuse are allresearch based curriculum that are supported by extensive research. Othercomprehensive curricula such as The Great Body Shop and Health Smart have beenshown to change behavior in random control trials, however replication has not beenshown in additional studies. 6
  • 7. Does the curriculum address the individual values that are important to students, doesit allow students to examine what they value?I’m working with several teachers who are teaching the Life Skills Training Curriculum,one teacher has addressed this characteristics by working with students to examinewhat they value about their families and friends. What do you value in a friend, and ina relationship this sparked some great discussion about what students really value.This discussion lead into an activity that allowed student to practice how theycommunicate with their friends and family. This communication is linked back to whatstudents value in a relationship.Also think about how you can shift from negative to positive social norms, whatpositive social norms can be supported in your teaching?Are group and social norms addressed. What do most middle school students thinkabout tobacco use at the middle and high school. Students consistently estimate that30 – 40% of students smoke in high school. In reality it’s closer to 17%. Changingexamining the mis-perceptions of norms and examining the positive social normsshould be encouraged. 7
  • 8. This goes back to behavior theory. Think about students some students will perceive this as a risky bet butother will bet the house and everything on this hand. What are the risk associated with betting on this hand?Youth in general are risk takers who feel invincible, they are not really influenced by the long-term risks. Forthis reason it is important to examine the immediate risks to a given behavior both positive or negative.We need to work to address the risks of injury or drug use and provide statistics that provide a clear,realistic message regarding the risks of drug use. For example the number of youth in Colorado that useMeth is very small but the potential dangers of addiction is very high. Telling students that they will die ifthey use drugs doesn’t cut it. Especially for those students who have parents, peers, siblings that use drugs.When you talk to kids about tobacco there will always be that one student who says yea but I have a grandmother who is 80 and has smoked since she was 16. Their perception of risk to tobacco use may be verydifferent for this student.One alarming statistic that we need to watch is the perception of risks around marijuana use, 52% of highschool seniors thought that marijuana had a great risk of harm if smoked regularly, this is down from 58% in2006. Marijuana use has increased compared to 2005 data from 22.7% to 24.8%. Looking at this trend as ahealth educator changing the social norms that we talked about in the previous slide and linking thepotential risks, as well as educating youth on the intent of medical marijuana laws will be important.In general we want to realistically portray the risk and harmfulness of specific behaviors and give studentsopportunities to assess their individual vulnerability. Thinking more broadly about the social determinants ofhealth the effects of SES, and race and ethnicity on the risks of disease is key information to share withstudent to give them an accurate picture of their individual or personal risk. 8
  • 9. Here we are talking not only about peer pressure but the influences from the media,and social pressures and barriers.Students analyze the influence the factors that influence healthy and unhealthybehaviors, how do families, peers, culture, media and technology influence behaviors.Tobacco print ads is a great place to start but tobacco advertisements are now bannedthanks to public health policies. Today examining how tobacco is portrayed in movieson TV, and online should be examined.Also consider how students are influenced by social media. The New Mexico Mediahttp://www.nmmlp.org/ literacy project is doing some wonderful work on analyzing themedia.What are the cultural factors influence the foods that we eat, and how are thoseengrained into the fabric of the community and pressure to conform? 9
  • 10. Addressing skills is a key to changing behavior. Think about developing a skill likehitting a baseball. You don’t start with a 90 mile and hour fast ball off the mound. Youstart with presenting the skill of hitting by breaking it down into steps, then practicingswinging without a ball. Then adding a T, soft toss, to soft pitch then off a mound.Then you get to a point where you can bat in a specific situation 2 outs 3 balls and 1strike with a runner on second. Well in health you need to think in the same termswhen you talk about teaching a skill like communication skills.Talking about the importance of learning the skill.Present steps to the skillModel the skillPractice and rehearse the skill using real life scenariosProvide feedback and reinforcementPersonal, social competency and students feeling like they can be effective in usingthe skills is important to examine in the curriculum. This semester we will bedeveloping this idea of skills development. 10
  • 11. 4,800 chemicals are found in tobacco smoke. What is the functional knowledge thatstudents need to take away in terms of this knowledge. How many chemicals dostudents need to really know?Does the curriculum provide accurate, reliable, and credible information for students.Is the information that is provided relevant to your students, and can they use it to helpthem make decisions and change behaviors.I taught way too much knowledge. Make the knowledge essential what are the bigideas that students need to know to make good decisions and move onto decisionmaking and communication. Think about how the facts you are teaching directly relateto changing a behavior or a skill. 11
  • 12. These 3 characteristics are grouped together on this slide. We will be spending a lot ofthis semester talking about what these practices are. One of the main focuses of thisclass is to develop an understanding of what a culturally responsive classrooms andcurriculum 12
  • 13. Short term one shot events are not going to change behavior. The effectiveness andquality of health education programs have been linked to adequate instructional timedevoted to health education in the classroom.The Joint Committee on National Health Education Standards recommends thatstudents in Pre-K to grade 2 receive a minimum of 40 hours and students in grades 3to 12 receive a minimum of 80 hours of instruction in health education per academicyear. It takes time to build skills in health education. In order to see behavior changerepeated practice of skills is needed and this takes time. 13
  • 14. Skills should be taught across a number of topic areas. For example the basic skill ofaccessing information can be taught in a nutrition unit then reinforced in a tobaccoprevention unit, or substance use and abuse unit.As a health educator the reality is that you do not have the time to teach all the skillsneeded in every topic area every year. For that reason having a clear scope andsequence that supports re-enforcement of the skills across topic areas is important. Itis also important to continue to reframe health education by reinforcing positivebehaviors that many students are engaged in. 14
  • 15. This may be difficult to do in a classroom but providing opportunities for students tothink about and connect with positive role models and influential people in thecommunity. A recent study findings show that those from a higher income family weremore likely to have a role model than those from a lower income family but overall59% reported that they had a role model. The type of role model was significantlyassociated with health related behaviors; those who identified a teacher as their rolemodel were more likely to show positive health related behaviors where as those whoidentified a peer or an entertainer role model were more likely to show health-riskbehaviors.Yancey, A.; Grant D.; Kurosky, S.; Kravitz-Wirtz, N.; Mistry, E. (2011) Role modeling,risk, and resilience in California adolescentsJournal of Adolescent Health (48), 1, 36-43 15
  • 16. Specific professional development that supports effective curriculum and supports thespecific needs of health educators is key. Often school trainings are geared towardsgeneral professional development for teachers as opposed to the specific needs ofhealth educators looking to change behaviors. This is an area that needs to beaddressed RMC is trying to provide this type of training. 16