Leigh Szucs (00:01):
Welcome to our video titled CDCs Health Education Curriculum Analysis Tool, violence prevention module updates. In 2021, CDC released an updated version of the HECAT to help translate research into practice and support schools in delivering quality health education. Today, we're excited to provide an overview of key updates for violence prevention. My name is Leigh Szucs and I'm a health scientist in CDCs Division of Adolescent and School Health known as DASH. In this role, I work on DASH's health and sexual health education portfolio, supporting research and programmatic activities with schools across the United States. I'm glad to be joined today by my colleague, Natalie Wilkins, also from CDC DASH. Natalie.
Natalie Wilkins (00:47):
Thanks Leigh. I'm Natalie Wilkins, and I'm a behavioral scientist here in DASH like Leigh. I also support research and programmatic activities with schools and school districts across the US, although I work mainly on promoting safe and supportive environments in schools. In today's presentation, we'll be talking about the impacts of violence on youth and practices and strategies for schools to keep youth safe. We'll be sharing an overview in recent updates to CDCs health education curriculum analysis tool or HECAT, and taking a deep dive into chapter six, the violence prevention module. We'll be highlighting new or revised student level knowledge and skill expectations that are important for universal primary prevention curriculum and we'll end our session today by sharing several tools and resources to help schools prevent violence and keep students safe.
Natalie Wilkins (01:39):
Let's begin by looking at recent data on the impacts of multiple forms of violence on today's youth. Preventing violence is key to promoting teen and adult health. A teen's brain is still growing. Experiencing violence during this time of life can harm development and contribute to impaired decision making, learning challenges, decreased connections to peers and adults, and trouble coping with stress. Violence can also affect teen's physical health and increase the chance of developing cancer, heart disease, or other health problems in adulthood. We can protect teens now and support their growth into healthy adults by preventing violence. In 2019 CDCs nationwide youth risk behavior survey, or YRBS was administered to high school students across the United States to monitor their experiences with multiple forms of violence, including safety at school, bullying, dating violence, and forced sex. According to 2019 YRBS results, which included data from 13,677 students. Among the approximately two thirds of US high school students who reported dating during the last 12 months before the survey 8.2% reported experiencing physical dating violence and 8.2% experienced sexual dating violence. One in four high school students reported being bullied on school property in the last year and notably females and sexual minority students experienced higher rates of dating violence, sexual violence, and bullying. Also teens who experience more types of violence have increasing health conditions and risk behaviors as seen in the charts here. This includes missing school due to safety concerns, overweight or obesity, feeling sad or hopeless, suicidal thoughts or behaviors, weapon carrying, substance use, and risky sexual behavior.
Natalie Wilkins (03:35):
From 2009 through 2019, there were improvements in some violence related behaviors while others remain the same or got worse. Notably, the percentage of students who reported that they did not attend school because of safety concerns has steadily increased over the last decade. We can protect youth and support their growth into healthy adults by preventing violence. To prevent youth violence we must understand and address the factors that put people at risk or protect them from violence. There are a number of factors listed here that may increase or decrease the risk of youth experiencing or perpetrating violence. Longstanding systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk for violence. It's important for prevention efforts to consider societal conditions that are disproportionately experienced by black youth and young adults, including concentrated poverty, residential segregation, and other forms of racism. That limits opportunities to grow up in healthy, violence free environments. Addressing the root causes of violence is critical for reducing rates of violence in communities of color. All students have the right to learn in a safe and supportive environment, including its school. The good news is school violence can be prevented. Research shows that prevention efforts by teachers, administrators, parents, community members, and even students can reduce violence and improve the school environment. Now I'll turn it over to Leigh to talk more about what schools can do. Leigh.
Leigh Szucs (05:01):
Thanks, Natalie. Many factors contribute to school violence prevention and specifically addressing those factors that put young people at risk for and protect them against violence is important. Schools can do strategies such as adopting policies and practices that create safe and supportive environments, teach young people skills and information to navigate social and emotional challenges, offer or link students to critical health services and build strong bonds between staff and students to improve connectedness to school. Schools are uniquely positioned to provide quality health education. As one of the key strategies, health education is the formal structured combination of planned learning experiences that provide the opportunity to acquire information and skills that young people need to make health promoting decisions, achieve health literacy, adopt health enhancing behaviors, and promote the health of others. Curriculum is one of the primary organizing frameworks for which health information and skills is delivered through schools.
Leigh Szucs (06:05):
So what exactly is a health education curriculum? According to CDC, health education curriculum includes five core components. One, a set of intended learning outcomes or objectives that directly relate to students acquisition of knowledge, attitudes and skills. Two, a planned progression of developmentally appropriate lessons or learning experiences that lead to achieving health behaviors or objectives. Three, continuity between lessons or learning experiences that clearly reinforce adoption and maintenance of health enhancing behaviors. Four, content and materials that correspond with the sequence of learning events and help teachers and students meet those learning objectives. And finally, five, assessment strategies to determine if students have achieved the desired learning through curriculum approaches. In order to strengthen school health education CDC created the health education curriculum analysis tool. As we've mentioned, HECAT is CDCs primary evidence informed resource for advancing health education through schools. The HECAT contains process guidance appraisal tools and resources for carrying out a clear, complete, and consistent examination of commercially available or locally developed health education curricula. Analysis results can help school and community leaders select or develop appropriate and effective health education curricula, revise and improve locally developed curricula or educational materials, and strengthen the delivery of health education to improve educators ability to support healthy behaviors and outcomes among youth.
Leigh Szucs (07:45):
The HECAT aligns with the national health education standards and CDCs 15 characteristics of effective health education curriculum. HECAT was designed for use by several groups, including state and local territorial or tribal health and education staff, curriculum committees, teams or educators at school districts or schools, youth serving community organizations, institutions of higher education and other pre-service teacher training programs, and commercial curriculum developers. As well mentioned in the beginning of this video, CDC recently updated the contents of HECAT based on emerging research on adolescent and school health, as well as practices from the field. As part of this update, HECAT is now available in two formats as you see displayed here. Users can access the tool via PDF manual available for download on CDCs healthy youth webpage, and as an interactive online application called HECAT online. Together these multiple user formats help to improve the accessibility and reach of the HECAT. Where we will spend the majority of our time today is in HECAT's chapter six. Chapter six includes 10 modules to address single health topic curricula or comprehensive health education curricula.
Leigh Szucs (09:08):
Each module contains a description of the health topic, including the healthy behavior outcomes or HBOs relevant for that curriculum in the selected topic area. All modules use the National Health Education Standards core concept standard one as the framework for analysis. This framework helps to determine the extent to which the curriculum is likely to enable students' mastery of the essential knowledge and skills needed to promote healthy behaviors. Because school curricula must meet local community needs and often align with state or local curriculum requirements, users are encouraged to review the list of HBOs knowledge and skill expectations, and all supporting resources before using any of the modules to begin analysis. HECAT users can add, delete or revise items from any of the chapters, including content of chapter six to help meet school youth and community health needs.
Leigh Szucs (10:08):
Now we'll take a deep dive into the violence prevention module. As Natalie described in the beginning, we'll highlight some new and revised student level knowledge and skill expectations that were recently part of the 2021 update. Let's start by talking about the healthy behavior outcomes. A pre-k through grade 12 violence prevention curriculum should enable students to achieve 10 healthy behavior outcomes. As you can see here, these range from managing conflict in non-violent ways to accessing and using help seeking behaviors for self and others. During the update process no new HBOs were added to this module. All 10 remain critical outcomes to be addressed through violence prevention curricula in schools for students across all grade levels. Before we talk about specific content updates, I want to take a moment to connect the healthy behavior outcomes with how HECATÕs knowledge and skill expectations can help schools analyze, select, or create violence prevention health curricula. 
Leigh Szucs (11:14):
When using the HECAT to analyze curricula, the first step is to identify the desired health behavior outcomes starting on the far-left hand side in orange. So, in this example, let's say the violence prevention curricula is designed for middle school students grade six through eight, and one of the desired outcomes is for students to manage interpersonal conflict in non-violent ways. The HECAT identifies what knowledge expectations shown in green in the middle column are aligned to help students achieve that behavioral outcome knowledge expectation, such as analyzing the risks of using violence as an impulse behavior or response to stress or conflict, as well as explaining why communicating effectively is important to resolve conflicts nonviolently may help students reach the behavioral outcome of interest. Every knowledge expectation found in HECAT is aligned or mapped with the healthy behavior outcome of interest. As you can see in the yellow highlight, HECAT users may also want to know what skills could help students build knowledge in order to reach the desired health behavior outcome.
Leigh Szucs (12:20):
As you can see in the last two boxes in blue skill expectations, including determining the value of applying thoughtful decision making to a potentially violent situation or demonstrating how to communicate empathy and support for others to prevent violence, may increase student's ability to master knowledge needed to demonstrate the desired health behavior outcome. The process of identifying the HBO and selecting relevant knowledge and skill expectations will likely be driven by local priorities and needs. However, HECAT users can use the tool to make systematic decisions about this process and improve and strengthen their violence prevention curricula across all grades pre-K through 12.
Leigh Szucs (13:06):
In HECAT recent updates in 2021, a number of key revisions were made, and I want to highlight several right now. First strengthening the knowledge and skill expectations were done related to identifying and labeling emotions, promoting friendship and effective communication skills, and gender-based violence prevention. New content about health seeking behaviors was added to improve suicide prevention. New and updated knowledge expectations can be found in all grade spans pre-K through 2, 3, 5, 6, 8, and grades nine through 12, as well as specificity to the skill expectations aligned with the national health education standards two through eight were made. Collectively these revisions were based on updated scientific findings and practice-based guidance from the field and in consultation with experts in adolescent health and violence prevention. Related to identifying and labeling emotions, new items beginning in grades three through five, included explained that anger and related emotions, for example fear, shame, and guilt, are normal and identifying health enhancing ways to express and deal with emotions can be found. 
Leigh Szucs (14:09):
In secondary grades new items included things such as explain that help is available for people who are feeling sad, hopeless, or thinking of hurting themselves, for example mental health services related to promoting friendship and effective communication skills. New items in younger grades included things such as describe examples of ways to be a good friend to others. In older grades new items, such as identifying a variety of nonviolent ways to respond to stress when angry or upset can be found in this module. The gender-based violence prevention updates included several items across multiple grade spans. For example, new knowledge expectations that describe how stigma bias prejudice can lead to discrimination and violence, as well as, describing the signs and symptoms of people who are in danger of hurting themselves or others can be found throughout the module.
Leigh Szucs (15:17):
Additionally, explicit focus on the role of technology and the impacts it has on youth violence were included. For example, new knowledge expectations in grades nine through 12 include analyzing technology and social media can be used in violent or harmful ways toward others. Also throughout the module, users will find new consent based language that reflect an increased attention on giving and receiving consent throughout the module while also maintaining developmental appropriateness. For example, one of the new knowledge expectations in grade nine through 12 explains why it is an individual or a partner's responsibility to verify that all sexual acts are consensual. Notably within HECATÕs mental and emotional health module, there are complimentary knowledge expectations for managing emotions and feelings using technology and help seeking behaviors for all grade spans. Users that are creating or analyzing violence prevention curricula are encouraged to review related modules like was mentioned mental and emotional health to look for relevant knowledge expectations that might inform their analysis process.
Leigh Szucs (16:30):
That concludes the deep dive into the updated knowledge expectations for students found in HECATÕs violence prevention module. We encourage users again to review the module in full before beginning systematic analysis of new or locally developed violence prevention curriculum. In this final section of the video, we will highlight some key tools and resources to help inform school violence prevention efforts. General resources for violence prevention that schools might find helpful include CDCs characteristics for effective health education. This resource highlights 15 characteristics of effective health education curricula based on a growing body of research and evaluation. The developing a scope and sequence for health education is a helpful resource that provides a step by step process to create or revise a scope and sequence across multiple health topic areas, including violence prevention. And lastly, the health education pacing guide unit planner is a practical tool that includes templates and guidance for schools when creating a pacing guide or unit plan in any health topic area, including violence prevention. To learn more about HECATÕs features, forms, updates, and how to use HECAY online check out CDCÕs HECATÕs frequently asked questions page.
Leigh Szucs (17:47):
To accompany the HECAT, CDC also created a series of new fact sheets, detailing the tools features and in-depth guidance on how to access and use HECAT online. Everything presented in this video can be found on CDCs healthy youth webpage. Additionally, CDCs tools for healthy schools offers a free eLearning training series about HECAT that overviews again key features of the tool and how it can be used. Both webpages and training resources offer much more detail about how to use the HECAT. Check them out today. Now I will turn it back to Natalie to talk about additional violence prevention resources and to close us out. Natalie
Natalie Wilkins (18:36):
CDC developed technical packages to help communities and states prioritize violence prevention strategies based on the best available evidence. The strategies and approaches in the technical packages are intended to address individual behaviors, as well as the relationship, family, school, community, and societal factors that influence risk and protective factors for violence. They're meant to work together and to be used in combination in a multi-level multi-sector effort to prevent violence. The technical package for youth violence prevention provides guidance on programs, practices, and policies with evidence of impact on youth violence, victimization, perpetration, and risk or protective factors for youth violence.
Natalie Wilkins (19:19):
The strategies and approaches included in CDCs technical package focus on multiple levels with efforts intended to impact individual behaviors, and also the relationships, families, schools, and communities that influence risk and protective factors for youth violence. The strategies and approaches are intended to work in combination and reinforce each other to prevent youth violence in a comprehensive and long-term way. While research suggests that developing youth's individual skills can reduce their risk for engaging in violence approaches, addressing relationships with parents, peers, and other caring adults, as well as approaches that influence school and community environments are equally important to have the greatest public health impact. In today's webinar, we have highlighted one key strategy, strengthened youth knowledge and skills through universal school- programs that can use CDCÕs HECAT as a guide. This concludes our webinar overviewing updates to CDCÕs HECAT violence prevention module. If you have any questions or need any additional assistance, please reach out to CDC. Thank you for spending your time with us today.