school health education

1. Comprehensive School
Health Education
Dr/ Eman M. Mortada
Associate professor
In public health and preventive medicine
2nd lecture Chapter 1: Nation at risk

2. Part 1:
Identify the risky behaviors in
adolescent students
Part 2:
Understand comprehensive School
Health Education Curriculum
Learning objectives
By the end of this lecture the students will be able to:

3. 11
The categories of
risky behaviors
in adolescent
students
Dr. Eman M. Mortada

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Adolescent age
 Adolescence, is a vital stage of growth and development,
 The period of transition from childhood to adulthood.
 It is characterized by rapid physiological changes and
psychosocial maturation.

5.  Early adolescence (ages 11-14) – first stages
of separation from parents, desire to look and
act like peers
 Middle adolescence (ages 15-17) – further
distancing from parents and allying with peers,
dangerous behaviors
 Late adolescence (ages 18-21) - fully identify
one’s own moral code, more confident and
better able to delay gratification, can be
protective factors Dr. Eman M. Mortada
Adolescence can be divided into 3 sections

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 As adolescents mature cognitively, their mental process becomes
more analytical. They are now capable of abstract thinking,
better articulation and of developing an independent ideology.
 These are truly the years of
 creativity,
 idealism, and
 a spirit of adventure.
Adolescents take risks

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But these are also the years of
 experimentation and
 risk-taking, of
 giving in to negative peer pressure,
 taking uninformed decisions on crucial
issues, especially relating to their
bodies and their sexuality.
Adolescence is thus a turning point in
one’s life, a period of increased potential
but also one of greater vulnerability.
Adolescents take risks

8. Risk Behaviors
 Most risk behaviors:
 Are established during youth, during 2nd decade of life (e.g., smoking,
substance use, physical inactivity, sexual behavior, driving, etc.)
 Persist into adulthood, Responsible for leading causes of morbidity/mortality
during adulthood
 Are preventable
 Cumulative Risks
 related risks that increase in effect with each added risk. (Co-occurrence of
risk behaviors )
e.g. using cell phone and driving
 Consequences of risk behaviors add up over time.
e.g. junk food
Dr. Eman M. Mortada

9. :
Dr / Eman Mortada

10. The Centers for Disease Control and Prevention
(CDC) has identified six of the most significant risk
behaviors for young people under age 24. These risk
factors can lead to heart disease, cancer, and other
serious illnesses later in life
1
2
3
4
5
6
Tobacco use
Unhealthy dietary behaviors
Inadequate physical activity
Alcohol and other drug use
Sexual behaviors
Behaviors that contribute
to injuries and violence
Six Categories Of Health-related Behaviors
Source: CDC (2013), http://www.cdc.gov/features/collegehealth
Dr. Eman M. Mortada

11. •Smoking Cigarettes, Cigars, Pipes
•Chewing Tobacco
•Most preventable cause of death in the U.S.
•Among young teens (11-14) about 1 in 5 smokes
worldwide.
• continue to smoke will be killed by tobacco-related illness.
•Teens are heavily influenced by tobacco advertising and
peer pressure.
•Worldwide, between 80,000 and 100,000 kids start
smoking every day- roughly half of whom live in Asia.
•29.2% male and 27.7% female are smokers (2001 Youth
Risk Behavior Survey)
Tobacco Use
Dr. Eman M. Mortada

12. Smoking vs chewing
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18. Teens are heavily influenced by
tobacco advertising and peer
pressure.
Dr. Eman M. Mortada

19. 100,000 kids start smoking/ day
Dr. Eman M. Mortada

20. 29.2% male and 27.7% female are smokers
Dr. Eman M. Mortada

21. • Chronic diseases are linked to poor eating habits
• More young people do not meet recommendations for
healthy eating
• Excess calories lead to obesity, which has doubled for
adolescents
• Almost one third of (27.3%) children and adolescents in
the United States are either overweight or obese.
• Adolescents and children often skip breakfast, which
affects performance
• Many adolescents develop eating disorders due to low
self-esteem, negative body image, or feelings of
inadequacy
Dietary Patterns that
Contribute to Disease
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23. Childhood obesity
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27. • Physical activity is body movement from skeletal muscles
that leads to energy expenditure
• Many young people do not get enough physical activity
• Fewer children are enrolling in daily P.E.
• Use of TV and video games contributes to this pattern
• Physical inactivity is a major contributor to death from
NCDs worldwide, The 4th risk factor for mortality
worldwide.
Insufficient Physical Activity
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30. WHO. Global health risks: mortality and burden of disease attributable to selected major risks. 2009.
http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.
Dr. Eman M. Mortada

31. • “Threatened or actual use of physical force or power
against another person, against oneself, or against a group
or community that either results in or has a high likelihood
of resulting in injury, death, or deprivation”
• Approximately 9% of US high school students report
lifetime history of sexual assault
• Victimization associated with future victimization,
depressive symptomatology, increased risk behaviors and
future suicide attempts
Violence
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9% of US high school students
report
sexual assault

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35. • Self-directed violence
• Piercing and/or Tattooing
• Cutting( Most common among adolescent girls (up to 14%)
• Suicide (the Third leading cause of death among
adolescents)
• Interpersonal violence
• Domestic violence (i.e., child abuse)
• Bullying and fighting
• Homicide (the second leading cause of death in
adolescents)
Intentional Injuries
Dr. Eman M. Mortada

36. • Caused by an Accident
• Unintentional injuries are leading cause of death for
children and teens
• In teenagers, unintentional injuries causes twice as many
deaths of intentional injuries
• The causes of unintentional injuries include
• Motor vehicle–related injuries
• Fires ( leading cause of death for children below age of
15)
• Drowning
• Others including: falls, suffocation, poisoning, etc.
Unintentional Injuries
Dr. Eman M. Mortada

37. • Cyber-Bullying
• Cliques
• Weapons
• Video Games Promoting Violence
Electronic & School Violence
Dr. Eman M. Mortada

38. • Drinking and drugs associated with:
• Unwanted sexual activity
• STDs
• Major factor in car accidents, physical fights,
• depression, suicide, and mental disorders.
• school failure
• Psychiatric co-morbidity
• Causes liver disease
• Certain types of cancers
• Heart disease
• Brain damage
• Worldwide, 5% of all deaths of young people between
the ages of 15 and 29 are attributable to alcohol use.
Alcohol And Drug Use
Dr. Eman M. Mortada

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40. • Sexual activity Outside of a mutually exclusive,
committed relationship, such as marriage,
• puts people at risk for health problems such as:
• STD’s,
• HIV infection,
• unplanned pregnancy…
• CDC estimates that nearly 20 million new STIs occur
every year in US, half among young people aged 15-24
• 1 IN 5 new HIV diagnosis in US occur in young people
aged 13-25
Sexual Behaviors
Dr. Eman M. Mortada

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43. Youth Risk Behavior Surveillance System (YRBSS)
 CDC has implemented a surveillance system, YRBSS
 That assesses these 6 categories of risky behavior in high school students
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Many of these images remind us that
students have numerous health challenges
and I encourage you, as educators, to ask
what you can do,
and what curriculum provides,
to empower youth to address these
challenges.

46. 12
Comprehensive
School Health
Education
Curriculum:
A Blueprint for
Implementing the National
Health Education
Standards

47. Comprehensive School Health Education
Curriculum
 This is an organized sequential
curriculum K-12 plan
 for teaching students the information and
skills they need
 to develop confident and competent
students
 who understand, appreciate, and apply
health knowledge, skills, and strategies
throughout life
Dr. Eman M. Mortada

48. Comprehensive School Health Education
Curriculum
 Become Health literate
 Maintain and improve their health
 Prevent disease
 Reduce health-related risk behaviors
 It address not only the physical, but also the mental, social
emotional and family dimensions of health and
 is tailored to each age level.
Dr. Eman M. Mortada

49. Grade Level
Emphasis
Alcohol,
Tobacco &
Other
Drugs
(ATOD)
Growth,
Development
and
Sexual
Health
(GDSH)
Nutrition &
Physical
Activity
(NPA)
Mental,
Emotional, &
Social Health
(MESH)
Personal &
Community
Health
(PCH)
Injury
Preventi
on &
Safety
(INJ)
Kindergarten
     
Grade 1   
Grade 2   
Grade 3   
Grade 4   
Grade 5    
Grade 6   
Grade 7/8       
High School       
Content Grade Level Assignments

50. Standards that specify what students should know and be able
to do.
Health education standards
What the students should know: basic information
What the students should do: basic skills
Dr. Eman M. Mortada
 Providing the basis for quality health education curriculum
 They involve the knowledge and skills essential to the
development of health literacy.

51. Overall Goal: Health Literacy
 Health literacy is the capacity of individuals to obtain,
interpret, and understand basic health information and
services and the competence to use such information and
services in ways that enhance health.
Dr. Eman M. Mortada
Obtain
Interpret
Understand

52. Overall Goal: Health Literacy
 When youth are health literate, they possess the skills that
protect them from 6 categories of risky behavior
Dr. Eman M. Mortada

53. Qualities of a Health-Literate Individual
Dr. Eman M. Mortada
a critical
thinker and
problem
solver
a
responsible,
productive
citizen
a self-
directed
learner
an effective
communicat
or
Four characteristics were identified as being essential to health
literacy. The health literate person is:
evaluating the possible outcomes before
making decisions
behaving in ways that improve home, school,
community, nation, and world
taking personal responsibility for gathering
and using health-related information
expressing health knowledge, beliefs, and
ideas

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56. The Meeks Heit Umbrella of Comprehensive School
Health Education
Illustrates how a curriculum can be Designed to protect youth from
the six categories of risk behaviors & develop healthy life skills:
Accessing Information
Analyze influences on health
Comprehend health knowledge
Use communication skills
Use resistance skills
Use conflict resolution skills
Make reasonable decisions
Set health goals
Practice healthful behavior
Managing stress
Be health advocate
Demonstrate good characterDr. Eman M. Mortada

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58. The Meeks Heit Umbrella of Comprehensive School
Health Education
Illustrates how a curriculum can be Designed to protect youth from
the six categories of risk behaviors & develop healthy life skills:
Accessing Information
Analyze influences on health
Comprehend health knowledge
Use communication skills
Use resistance skills
Use conflict resolution skills
Make reasonable decisions
Set health goals
Practice healthful behavior
Managing stress
Be health advocate
Demonstrate good characterDr. Eman M. Mortada

59. Comprehend health knowledge
– Health knowledge
The accumulation of factual information that influences
health decision making.
comprehend health concepts related to health promotion and
disease prevention.
Dr. Eman M. Mortada

60. Analyzing Influences
Analyzing influences involves recognizing factors that affect or
influence health
Internal influences,
 which include knowledge, values, likes, dislikes, and desires,
 are based on experiences and your perspective on life
External influences, which come from outside sources, include
 your family,
 your friends, and peers,
 your environment,
 your culture,
 laws and the media
Dr. Eman M. Mortada

61.  Influences can be internal or external.
Dr. Eman M. Mortada

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63. Accessing Information
– accessing useful health information, help make decisions
about products or services and choose behaviors that will
keep people healthy.
Reliable Sources of Health Information
•Parents, guardians, and other trusted adults
•Library resources
•Reliable Internet sites
•Newspapers and magazines
•Government agencies and health organizations
Dr. Eman M. Mortada

64. Interpersonal Communication
One of the traits of a health-literate individual is having effective
communication skills. The exchange of thoughts, feelings, and beliefs between
2 or more people.
Interpersonal communication involves not only making yourself heard but also
being a good listener.
Effective communication skills involve:
• Clearly say what you mean.
• Pay attention to how you say something: tone of voice, facial expressions,
& body language
• Be a good listener: don’t interrupt, nod head & ask questions when
appropriate

65. Clearly say what you mean
 Use “I” messages to state your position,
 This helps you avoid placing blame on others

66. Pay attention to how you say something
 Make sure your facial expressions and gestures reflect your verbal message

67. Be a good listener
 Avoid interrupting the speaker,
 and show that you are listening by
 nodding or
 asking appropriate questions

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 Think about how you handle situations in which
you are asked to do something that you know is
harmful or wrong
In such circumstances,
you need to use
Refusal Skills

69. Refusal Skills
S
T
O
P
Say no in a firm voice.
Tell why not.
Offer another idea.
Promptly leave.
Refusal skills are especially important during in teen years.
Refusal skills: Communication strategies that can help you say no
when you are urged to take part in
behaviors that are:
 unsafe or
 unhealthful, or
 that go against your
values.
Dr. Eman M. Mortada

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In addition to practicing
effective refusal skills,
it is important to develop strategies
for dealing with conflicts

72. Conflict Resolution
Conflict resolution: Solving a disagreement in a way that
satisfies both sides
Conflict resolution skills: will help prevent conflicts
from getting out of hand.
Key: respecting the other person’s rights as well as your
own.
Take time to calm down
and think through the
situation.
Steps When Dealing with a Conflict Situation
When discussing the
conflict, speak calmly and
listen attentively, asking
questions when appropriate.
Use a polite tone and try to
brainstorm solutions where no
one loses respect. Dr. Eman M. Mortada

73. Making Responsible Decisions
Step 1 Step 2 Step 3
Step 4 Step 5 Step 6
State the
Situation
that requires
a decision.
List All
Possible
Solutions Or
Choices
Weigh the
Possible
Outcomes
Considering
Values
Make a
Decision and
Act
Evaluate
Decision
The Decision-Making Process
The Responsible Decision-Making Model is a series of
steps to follow to assure that people make good decisions.

74. State the Situation
Define The Problem

75. List All Possible Solutions Or Choices
List All Possible Solutions Or Choices:
A.__________B._________C.____________

76.  You may also want to ask yourself the following questions
about each choice:
 (H) healthful – will my choice affect my well-being or the well-being of
others.
 (E) Ethical – will my choice show respect for myself and other people.
 (L) Legal – will I be breaking the law? Is it legal for someone my age?
 (P) parent approval – would my parents approve of my decision?
When weighing choices use the
H.E.L.P formula.
Weigh the Possible Outcomes
Choice a
• Pros
• Cons
Choice B
• Pros
• Cons
Choice C
• Pros
• Cons

77. The Decision-Making Process
The HELP Strategy
When weighing the options for any decision, asking yourself these questions:
H
E
L
P
(Healthful) Does this choice present any health risks?
(Ethical) Does this choice reflect what you value?
(Legal) Does this option violate any local, state,
or federal laws?
(Parent Approval) Would your parents or guardians
approve of this choice?

78. The Decision-Making Process
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
Steps of the Decision-Making Process
State the Situation.
List the Options.
Weigh the Possible Outcomes.
Consider Values.
Make a Decision and Act on It.
STEP 6 Evaluate the Decision.

79. Evaluate Decision
 If the outcome is not what you expected then use the decision
making process and try again.
What was the outcome?
How did you feel about your
decision?
Would you make the same
choice again next time?
What did you learn?
Did your decision effect
others?

80. What responsible decisions have you made in the past week?
This teen made the
decision to study for his
exam instead of going out
with friends.
MAKING RESPONSIBLE DECISIONS AND SETTING
GOALS

81.  Working toward something you want to accomplish
 A health goal is a healthful behavior a person works to
achieve and maintain.
– A healthful behavior a person plans to achieve in the
near future is a short-term health goal.
– A healthful behavior a person plans to achieve after a
period of time is a long-term health goal.
Set health goals
Dr. Eman M. Mortada
Make your
goals
specific
List the
steps
to reach
your
goal
Get help
from
others
Evaluate
your
progress
Reward
yourself

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83. Goals Should Be SMART
Specific: who, what, where, when?
Measurable: how much, how many?
Attainable: Do you have the skills to reach it?
Realistic: is it something you are actually capable of
doing?
Timely: when will you be able to reach this goal by?

84. Practicing Healthful Behaviors
I eat well-balanced meals and choose
healthful snacks.
I get regular daily physical activity
and at least 8 hours of sleep /night.
I avoid using tobacco, alcohol, and
other drugs.
I understand health benefits of
brushing and flossing teeth regularly.
I understand benefits of wearing a
safety belt every time I ride
I stay within 5 pounds of my healthy
weight.
I practice good personal hygiene
habits.
I get regular physical checkups.
I can name several things I do well.
I generally keep a positive
attitude.
The skill of practicing healthful behaviors can help balance
health triangle.
Dr. Eman M. Mortada

85. I express my emotions in healthy
ways.
I ask for help when I need it.
I take responsibility for my actions
I take on new challenges to improve
myself.
I relate well to family, friends, and
peers.
I have several close friends.
I can disagree with others without
becoming rude.
I treat others with respect.
I use refusal skills to avoid risk
behaviors.
I get along with all kinds of people.
Practicing Healthful Behaviors
Dr. Eman M. Mortada

86. Stress Management
Ways to deal with or overcome the negative effects of stress:
 Engage in physical activity
 Listening to soothing music
 Managing time effectively
 Taking a warm bath
Dr. Eman M. Mortada
• What are some activities you do to relieve stress?
Stress: the body’s reactions to everyday demands
Stress management: ways to deal with or overcome
the negative effects of stress

87. Advocacy
Advocacy: Informing others about health practices
and encouraging healthful behaviors
Dr. Eman M. Mortada
 Advocacy enables you to
positively influence the health
of those around you.
 Encouraging family, friends,
peers, and community members
to practice healthful
behaviors is one way to
practice health advocacy.

88. The ten content areas for which students gain
knowledge and use skills to achieve health goals
The curriculum is comprehensive and include a variety of
topics
 Mental and Emotional Health
 Family and Social Health
 Growth and Development
 Nutrition
 Personal Health and Physical Activity
 Alcohol, Tobacco, and Other Drugs
 Communicable and Chronic Disease
 Consumer and Community Health
 Environmental Health
 Injury Prevention and Safety Dr. Eman M. Mortada

89. Health goals for Mental and Emotional Health
1. I will develop good character.
2. I will interact in ways that help create a positive
social-emotional environment.
3. I will develop healthful personality characteristics.
4. I will choose behaviors that promote a healthy
mind.
5. I will express emotions in healthful ways.
6. I will use stress-management skills.
7. I will seek help if I feel depressed.
8. I will use suicide prevention strategies when
appropriate.
9. I will cope with loss and grief in healthful ways.
10. I will be resilient during difficult times

90. Health goals for Family and Social Health
11. I will develop healthful family relationships.
12. I will work to improve difficult family relationships.
13. I will make healthful adjustments to family changes.
14. I will develop healthful friendships.
15. I will develop healthful dating skills.
16. I will choose to practice abstinence from sex.
17. I will recognize harmful relationships.
18. I will develop skills to prepare for marriage.
19. I will develop skills to prepare for parenthood.
20. I will choose to practice abstinence from sex to avoid the
risks
of teen marriage and parenthood.

91. Health goals for Growth and Development
21. I will keep my body systems healthy.
22. I will recognize habits that protect female reproductive health.
23. I will recognize habits that protect male reproductive health.
24. I will learn about pregnancy and childbirth.
25. I will learn about the growth and development of infants
and children.
26. I will provide responsible care for infants and children.
27. I will develop my learning style.
28. I will achieve the developmental tasks of adolescence.
29. I will develop habits that promote healthful aging.
30. I will share my feelings with my family about dying and death.

92. Health goals for Nutrition
31. I will select foods that contain nutrients.
32. I will evaluate food labels.
33. I will eat the recommended servings from the
MyPyramid food guidance system.
34. I will follow the Dietary Guidelines when I eat out.
35. I will follow a healthful diet that reduces the risk of
disease.
36. I will develop healthful eating habits.
37. I will follow Dietary Guidelines when I go out to eat.
38. I will protect myself from food-borne illnesses.
39. I will maintain a desirable weight and body composition.
40. I will develop skills to prevent eating disorders.

93. Health goals for Personal Health and Physical Activity
41. I will have regular physical examinations.
42. I will follow a dental health plan.
43. I will be well-groomed.
44. I will get adequate sleep and rest.
45. I will participate in regular physical activity.
46. I will follow a physical fitness plan.
47. I will develop and maintain health-related and skill-related fitness.
48. I will be a responsible spectator and participant in sports.
49. I will try to prevent physical activity-related injuries and illnesses

94. Health goals for Alcohol, Tobacco, and Other Drugs
50. I will follow guidelines for the safe use of prescription and OTC drugs.
51. I will not drink alcohol.
52. I will avoid tobacco use and secondhand smoke.
53. I will not be involved in illegal drug use.
54. I will avoid risk factors and practice protective factors for drug
misuse and abuse.
55. I will not misuse or abuse drugs.
56. I will use resistance skills if I am pressured to misuse or abuse drugs.
57. I will choose a drug-free lifestyle to reduce the risk of violence
and accidents.
58. I will choose a drug-free lifestyle to reduce the risk of HIV infections and unplanned pregnancy.
59. I will be aware of resources for the treatment of drug misuse
and abuse.

95. Health goals for Communicable and Chronic Disease
60. I will choose behaviors to reduce my risk of infection with
communicable diseases.
61. I will be aware of immunizations that protect health.
62. I will choose behaviors to reduce my risk of infection with
respiratory diseases.
63. I will recognize ways to manage asthma and allergies.
64. I will choose behaviors to reduce my risk of infection with
sexually transmitted diseases.
65. I will choose behaviors to reduce my risk of HIV infection.
66. I will choose behaviors to reduce my risk of cardiovascular
diseases.
67. I will choose behaviors to reduce my risk of diabetes.
68. I will recognize ways to manage chronic health conditions.
69. I will choose behaviors to reduce my risk of cancer.

96. Health goals for Consumer and Community Health
70. I will acquire knowledge of laws to protect health.
71. I will recognize my rights as a consumer.
72. I will take action if my consumer rights are violated.
73. I will make a plan to manage time and money.
74. I will choose healthful entertainment.
75. I will analyze ways that messages delivered through technology might affect health
status.
76. I will make responsible choices about health-care providers
and facilities.
77. I will evaluate ways to pay for health care.
78. I will investigate health careers.
79. I will investigate public and international health needs.

97. Health goals for Environmental Health
 80. I will stay informed about environmental issues.
 81. I will be aware of organizations that protect the environment.
 82. I will help keep the air clean.
 83. I will help keep the water safe.
 84. I will help keep noise at a safe level.
 85. I will help improve the visual environment.
 86. I will help conserve energy and natural resources.
 87. I will help reduce and dispose of waste.
 88. I will protect the natural environment.
 89. I will be a health advocate for the environment.

98. Health goals for Injury Prevention and Safety
90. I will follow safety guidelines to reduce the risk of
unintentional injuries.
91. I will follow guidelines for motor vehicle safety.
92. I will follow safety guidelines for severe weather, natural disasters, and national alerts.
93. I will practice protective factors to reduce the risk of violence.
94. I will respect authority and obey laws.
95. I will practice strategies to help protect myself from
physical violence.
96. I will practice strategies to help protect myself from sexual violence.
97. I will stay away from gangs.
98. I will follow guidelines to help reduce the risk of weapon injuries.
99. I will be skilled in common first aid procedures.
100. I will be skilled in emergency first aid procedures