ITEM RATIONALE
2006 SCHOOL HEALTH PROFILES
QUESTIONNAIRE FOR LEAD HEALTH EDUCATION TEACHERS

REQUIRED HEALTH EDUCATION COURSES

Question 1:  Is a required health education course taught for students in any of grades 6 through 12 in this school?

Question 2:  Are teachers in this school required to use each of the following materials in a required health education course for students in grades 6 through 12? 

Rationale:  These questions measure the extent to which health education courses are required for students in grades 6 through 12 and the extent to which teachers are required to use specific materials.  School health education could be one of the most effective means to reduce and prevent some of the most serious health problems in the U.S., including cardiovascular disease, cancer, motor-vehicle crashes, homicide, and suicide.1  The Institute of Medicine (IOM) has recommended that U.S. schools require a one-semester health education course at the secondary school level;1 however, the benefits of a health education curriculum increase when students receive at least three consecutive years of quality health curriculum.2  

Question 3:  During this school year, have teachers in this school tried to increase student knowledge on each of the following topics in a required health education course in any of grades 6 through 12?

Question 4:  During this school year, have teachers in this school tried to improve each of the following student skills in a required health education course in any of grades 6 through 12? 

Question 5:  During this school year, how often have teachers in this school used each of the following teaching methods in a required health education course in any of grades 6 through 12?

Question 6:  During this school year, have teachers in this school used each of the following teaching methods to highlight diversity or the values of various cultures in a required health education course in any of grades 6 through 12?  

Question 7:  During this school year, have teachers in this school asked students to participate in each of the following activities as part of a required health education course in any of grades 6 through 12?

Rationale:  These questions measure the extent to which schools are complying with components of the National Health Education Standards, which provide a framework for decisions about the lessons, strategies, activities, and types of assessment to include in a health education curriculum.4  The goal of the national standards is to improve educational achievement and student health in the United States.  The National Health Education Standards Project also seeks to increase health literacy among students to include critical thinking and problem solving, responsible and productive citizenship, self-directed learning, and effective communication.  Additionally, the standards identify knowledge and skills organized around traditional health content areas and risk behaviors.  

Question 8:  During this school year, did teachers in this school teach each of the following tobacco use prevention topics in a required health education course for students in any of grades 6 through 12?

Rationale:  This question measures the prevalence of teaching tobacco-use prevention topics in required health education courses, which meet the CDC Guidelines for School Health Programs to Prevent Tobacco Use and Addiction.  Tobacco-use prevention topics provide instruction about the short- and long-term negative health consequences of tobacco use, social influences on tobacco use, peer norms regarding tobacco use, and refusal skills.5  Results from the 2003 national Youth Risk Behavior Survey indicated that nationwide, 18.3% of high school students had smoked a whole cigarette before age 13.  Furthermore, male high school students (20%) were significantly more likely than female students (16.4%) to have reported smoking a whole cigarette before age 13.6 

Question 9:  During this school year, did teachers in this school teach each of the following pregnancy, HIV, or STD prevention topics in a required health education course for students in any of grades 6 through 12?

Rationale:  This question measures the prevalence of instruction on pregnancy, HIV, or STD prevention topics in required health education courses.  Kirby et al (1994) reviewed 24 studies of school-based programs designed to reduce sexual risk behaviors and identified many of these topics as essential to effective risk-prevention programs.7  Results from the 2003 national Youth Risk Behavior Survey indicated that nationwide, 87.9% of high school students had been taught about acquired immunodeficiency syndrome (AIDS) or HIV infection in school.6 

Question 10:  During this school year, did teachers in this school teach each of the following nutrition and dietary topics in a required health education course for students in any of grades 6 through 12?

Rationale:  This question measures the prevalence of instruction on nutrition and dietary topics in required health education courses.  Data from the 2003 YRBS revealed that nationwide, 14.8% of high school students were at risk of becoming overweight, while 12.1% of high school students were already classified as being overweight.6  The CDC Guidelines for School Health Programs to Promote Lifelong Healthy Eating indicate that the primary goal of nutrition education should be helping young persons adopt healthy eating behaviors that will aid in reducing the risk for disease.8

Question 11:  During this school year, did teachers in this school teach each of the following physical activity topics in a required health education course for students in any of grades 6 through 12?

Rationale:  This question measures the prevalence of physical activity topics taught in required health education courses.  The Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young People recommend that health education curricula provide information about physical activity concepts including the physical, social, and mental health benefits of physical activity; the components of health-related fitness; principles of exercise; injury prevention and first aid; precautions for preventing the spread of bloodborne pathogens; nutrition, physical activity, and weight management; social influences on physical activity; and the development of safe and effective individualized physical activity programs.9

HIV PREVENTION

Question 12:  Are required HIV prevention units or lessons taught in each of the following courses in this school?

Rationale: This question measures the extent to which HIV-infection prevention lessons were infused into the curriculum through integration with other subjects.  While integration of health information and skills into other subjects should not replace stand-alone health classes, such integration can reinforce and extend the health education curriculum.2

COLLABORATION

Question 13:  During this school year, have any health education staff worked with each of the following groups on health education activities?

Question 14:  During this school year, has this school done each of the following activities?

Rationale:  These questions measure the extent to which health education staff work cooperatively with other components of the school health program (school health services, school mental health or social services, food service, and physical education staff) and families.  An integrated school and community approach is an effective strategy to promote adolescent health and well being.10 

STAFF DEVELOPMENT

Question 15:  During the past two years, did you receive staff development (such as workshops, conferences, continuing education, or any other kind of in-service) on each of the following health education topics?

Question 16:  Would you like to receive staff development on each of these health education topics?

Question 17:  During the past two years, did you receive staff development (such as workshops, conferences, continuing education, or any other kind of in-service) on each of the following topics?
QUESTION 18:  Would you like to receive staff development on each of these topics?

Rationale:  These questions measure the extent to which staff development on health education topics is received and desired.  Effective implementation of school health education is linked directly to adequate teacher training programs.  School health education designed to decrease students’ participation in risk behaviors requires that teachers have appropriate training to develop and implement school health education curricula.11  Staff development activities for health education teachers need to focus on teaching strategies that both actively engage students and facilitate their mastery of critical health information and skills.2

PROFESSIONAL PREPARATION

Question 19:  What was the major emphasis of your professional preparation?

Question 20:  Currently, are you certified, licensed, or endorsed by the state to teach health education in middle/junior high school or senior high school?

Question 21:  Including this school year, how many years of experience do you have teaching health education classes or topics?

Rationale:  These questions measure the extent to which lead health education teachers are formally trained in the topic of health education as well as the teaching experience and credentials of the lead health education teacher.  Health education teachers need to be academically prepared and specifically qualified on the subject of health.12

REFERENCES

1.	Institute of Medicine.  Schools and Health: Our Nation’s Investment.  Washington, DC: National Academy Press; 1997.

2.	Lohrmann DK, Wolley SF.  Comprehensive School Health Education.  In: Marx E, Wooley SF, eds.  Health is Academic.  New York: Teachers College Press; 1998: 43–66.

3.	Kann L, Brener N, Allensworth D.  Health education: results from the School Health Policies and Programs Study 2000. Journal of School Health 2000;71:266–278.

4.	Joint Committee on National Health Education Standards.  Achieving Health Literacy: An Investment in the Future.  Atlanta, GA: American Cancer Society; 1995.

5.	CDC. Guidelines for school health programs to prevent tobacco use and addiction. MMWR 1994;43 (No. RR-2).

6.	Grunbaum JA, Kann L, Kinchen S, et al. Youth risk behaviors surveillance – United States, 2003. MMWR 2004;53(SS-2). 

7.	Kirby D, Short L, Collins J, et al. School-based programs to reduce sexual risk behaviors: A review of effectiveness.  Public Health Reports 1994;109:339–360.

8.	CDC. Guidelines for school health programs to promote lifelong healthy eating.  MMWR 1996;45 (No. RR-9).

9.	CDC. Guidelines for school and community programs to promote lifelong physical activity among young people.  MMWR 1997;46 (No. RR-6).

10.	Allensworth D, Kolbe L. The comprehensive school health program: state of the art.  Journal of School Health 1987;63:14–20.

11.	Allensworth, D. Health education: state of the art.  Journal of School Health 1993;63:14–20.

12.	National Commission on the Role of the School and the Community to Improve Adolescent Health.  Code Blue: Uniting for Healthier Youth.  Alexandria, VA: National Association of State Boards of Education; 1990