Characteristics of an Effective Health Education Curriculum
Today’s state-of-the-art health education curricula reflect the growing body of research that emphasizes
- Teaching functional health information (essential knowledge)
- Shaping personal values and beliefs that support healthy behaviors
- Shaping group norms that value a healthy lifestyle
- Developing the essential health skills necessary to adopt, practice, and maintain health-enhancing behaviors.
Less effective curricula often overemphasize teaching scientific facts and increasing student knowledge.
An effective health education curriculum has the following characteristics, according to reviews of effective programs and curricula and experts in the field of health education:1-14
- Focuses on clear health goals and related behavioral outcomes.
An effective curriculum has clear health-related goals and behavioral outcomes that
are directly related to these goals. Instructional strategies and
learning experiences are directly related to the behavioral outcomes.
- Is research-based and theory-driven. An effective curriculum has instructional strategies and
learning experiences built on theoretical approaches (for example, social
cognitive theory and social inoculation theory) that have effectively influenced
health-related behaviors among youth. The most promising curriculum goes beyond the
cognitive level and addresses health determinants, social factors, attitudes,
values, norms, and skills that influence specific health-related behaviors.
- Addresses individual values, attitudes, and beliefs. An effective curriculum fosters attitudes, values, and beliefs that support positive health behaviors. It provides instructional strategies and learning experiences that motivate students to critically examine personal perspectives, thoughtfully consider new arguments that support health-promoting attitudes and values, and generate positive perceptions about protective behaviors and negative perceptions about risk behaviors.
- Addresses individual and group norms that support health-enhancing behaviors. An effective curriculum provides instructional strategies and learning experiences to help students accurately assess the level of risk-taking behavior among their peers (for example, how many of their peers use illegal drugs), correct misperceptions of peer and social norms, emphasizes the value of good health, and reinforces health-enhancing attitudes and beliefs.
- Focuses on reinforcing protective factors and increasing perceptions of personal risk and harmfulness of engaging in specific unhealthy practices and behaviors. An effective curriculum provides opportunities for students to validate positive health-promoting beliefs, intentions, and behaviors. It provides opportunities for students to assess their vulnerability to health problems, actual risk of engaging in harmful health behaviors, and exposure to unhealthy situations.
- Addresses social pressures and influences. An effective curriculum provides
opportunities for students to analyze personal and social pressures to engage in
risky behaviors, such as media influence, peer pressure, and social barriers.
- Builds personal competence, social competence, and self efficacy by
addressing skills. An effective curriculum builds essential skills — including
communication, refusal, assessing accuracy of information, decision-making,
planning and goal-setting, self-control, and self-management — that enable
students to build their personal confidence, deal with social pressures, and avoid or reduce risk behaviors.
For each skill, students are guided through a series of developmental steps:
- Discussing the importance of the skill, its relevance, and relationship to other learned skills.
- Presenting steps for developing the skill.
- Modeling the skill.
- Practicing and rehearsing the skill using real–life scenarios.
- Providing feedback and reinforcement.
- Provides functional health knowledge that is basic, accurate,
and directly contributes to health-promoting decisions and behaviors.
An effective curriculum provides accurate, reliable, and credible information for
usable purposes so students can assess risk, clarify attitudes and beliefs, correct misperceptions about
social norms, identify ways to avoid or minimize risky situations, examine
internal and external influences, make behaviorally relevant decisions, and
build personal and social competence. A curriculum that provides information for
the sole purpose of improving knowledge of factual information will not change behavior.
- Uses strategies designed to personalize information and engage
students. An effective curriculum includes instructional strategies and learning experiences
student-centered, interactive, and experiential (for example, group discussions,
cooperative learning, problem solving, role playing, and peer-led activities).
Learning experiences correspond with students’ cognitive and emotional
development, help them personalize information, and maintain their interest and
motivation while accommodating diverse capabilities and learning styles.
Instructional strategies and learning experiences include methods for
- Addressing key health-related concepts.
- Encouraging creative expression.
- Sharing personal thoughts, feelings, and opinions.
- Thoughtfully considering new arguments.
- Developing critical thinking skills.
- Provides age-appropriate and developmentally-appropriate
information, learning strategies, teaching methods, and materials.
An effective curriculum addresses students’ needs, interests, concerns, developmental
and emotional maturity levels, experiences, and current knowledge and skill
levels. Learning is relevant and applicable to students’ daily lives. Concepts
and skills are covered in a logical sequence.
- Incorporates learning strategies, teaching methods, and materials
that are culturally inclusive. An effective curriculum has materials that are free of
culturally biased information but includes information, activities, and
examples that are inclusive of diverse cultures and lifestyles (such as gender,
race, ethnicity, religion, age, physical/mental ability, appearance, and sexual orientation).
Strategies promote values, attitudes, and behaviors that acknowledge the
cultural diversity of students; optimize relevance to students from multiple
cultures in the school community; strengthen students’ skills necessary to
engage in intercultural interactions; and build on the cultural resources of
families and communities.
- Provides adequate time for instruction and learning.
An effective curriculum provides enough time to promote understanding of key health
concepts and practice skills. Behavior change requires an intensive and
sustained effort. A short-term or “one shot” curriculum, delivered for a few hours at one
grade level, is generally insufficient to support the adoption and maintenance
of healthy behaviors.
- Provides opportunities to reinforce skills and positive health
behaviors. An effective curriculum builds on previously learned concepts and skills
and provides opportunities to reinforce health-promoting skills across health
topics and grade levels. This can include incorporating more than one
practice application of a skill, adding "skill booster” sessions at subsequent
grade levels, or integrating skill application opportunities in other academic
areas. A curriculum that addresses age-appropriate determinants of behavior across
grade levels and reinforces and builds on learning is more likely to achieve
- Provides opportunities to make positive connections with
influential others. An effective curriculum links students to other influential
persons who affirm and reinforce health–promoting norms, attitudes, values, beliefs, and behaviors.
Instructional strategies build on protective factors that promote healthy
behaviors and enable students to avoid or reduce health risk behaviors by
engaging peers, parents, families, and other positive adult role models in
- Includes teacher information and plans for professional development and training that enhance effectiveness of instruction and student learning. An effective curriculum is implemented by teachers who have a personal interest in promoting positive health behaviors, believe in what they are teaching, are knowledgeable about the curriculum content, and are comfortable and skilled in implementing expected instructional strategies. Ongoing professional development and training is critical for helping teachers implement a new curriculum or implement strategies that require new skills in teaching or assessment.
- Botvin GJ, Botvin EM, Ruchlin H. School-Based Approaches to Drug Abuse Prevention: Evidence for Effectiveness and Suggestions for Determining Cost-Effectiveness. In: Bukoski WJ, editor. Cost-Benefit/Cost-Effectiveness Research of Drug Abuse Prevention: Implications for Programming and Policy. NIDA Research Monograph, Washington, DC: U.S. Department of Health and Human Services, 1998;176:59–82.
- Contento I, Balch GI, Bronner YL. Nutrition education for school-aged children. Journal of Nutrition Education 1995;27(6):298–311.
- Eisen M, Pallitto C, Bradner C, Bolshun N. Teen Risk-Taking: Promising Prevention Programs and Approaches. Washington, DC: Urban Institute; 2000.
- Gottfredson DC. School-Based Crime Prevention. In: Sherman LW, Gottfredson D, MacKenzie D, Eck J, Reuter P, Bushway S, editors. Preventing Crime: What Works, What Doesn’t, What’s Promising. National Institute of Justice; 1998.
- Kirby D. Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy; 2001.
- Kirby D, Coyle K, Alton F, Rolleri L, Robin L. Reducing Adolescent Sexual Risk: A Theoretical Guide for Developing and Adapting Curriculum-Based Programs. Scotts Valley, CA: ETR Associates; 2011.
- Lohrmann DK, Wooley SF. Comprehensive School Health Education. In: Marx E, Wooley S, Northrop D, editors. Health Is Academic: A Guide to Coordinated School Health Programs. New York: Teachers College Press; 1998:43–45.
- Lytle L, Achterberg C. Changing the diet of America’s children: what works and why? Journal of Nutrition Education 1995;27(5):250–60.
- Nation M, Crusto C, Wandersman A, Kumpfer KL, Seybolt D, Morrissey-Kane, E, Davino K. What works: principles of effective prevention programs. American Psychologist 2003;58(6/7):449–456.
- Stone EJ, McKenzie TL, Welk GJ, Booth ML. Effects of physical activity interventions in youth. Review and synthesis. American Journal of Preventive Medicine 1998;15(4):298–315.
- Sussman, S. Risk factors for and prevention of tobacco use. Review. Pediatric Blood and Cancer 2005;44:614–619.
- Tobler NS, Stratton HH. Effectiveness of school-based drug prevention programs: a meta-analysis of the research. Journal of Primary Prevention 1997;18(1):71–128.
- U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People–An Update: A Report of the Surgeon General. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2011: 6-22–6-45.
- Weed SE, Ericksen I. A Model for Influencing Adolescent Sexual Behavior. Salt Lake City, UT: Institute for Research and Evaluation; 2005. Unpublished manuscript.