What Works In Schools: Quality Health Education
CDC’s What Works In Schools Program improves the health and well-being of middle and high school students by:
- Improving health education,
- Connecting young people to the health services they need, and
- Making school environments safer and more supportive.
Health education is part of the primary mission of schools. It provides young people with the knowledge and skills they need to become successful learners and healthy adults.1
Health education is a fundamental part of an overall school health program and helps youth acquire functional health knowledge, strengthens attitudes and beliefs, and builds skills needed to adopt and maintain healthy behaviors throughout their lives.1
Health education is effective at addressing adolescent behaviors and experiences
Youth behaviors and experiences set the stage for healthy adulthood.2-4 In particular, health behaviors and experiences related to early sexual initiation, violence, and substance use are consistently linked to poor grades and test scores and lower educational attainment, as well as other negative health outcomes.5-14
Research suggests that well-designed and well-implemented school health programs can influence multiple health outcomes, including reducing risk behaviors related to sexually transmitted infections (STIs), including HIV, and unintended pregnancy, decreasing substance and tobacco use, and improving academic performance.5,6,15,16
Providing health education as early as possible can help youth develop positive well-being, academic success, and healthy outcomes into adulthood.17
Health Education Curriculum and Standards
Quality health education starts with a quality curriculum and student learning standards. CDC provides guidance and tools to help schools use curricula that meets their specific needs.
District and school staff can use CDC’s Health Education Curriculum Analysis Tool (HECAT) to analyze, select, or develop curriculum based on meeting adolescent health needs and community priorities.1
Health education curriculum should include:
- A set of learning outcomes or objectives that focus on students gaining health-related knowledge, attitudes, and skills.
- A planned progression of lessons or learning experiences that are developmentally appropriate, build on one another over time, and lead to achieving learning and health objectives.
- Lessons or learning experiences connect to each other and reinforce important health-enhancing behaviors.
- Content or materials follow a planned order and help teachers and students meet the learning objectives.
- Assessment strategies to measure whether students have gained health-related knowledge, attitudes, and skills.
Health education standards are designed to establish, promote, and support health-enhancing behaviors for students in all grade levels.1 These learning standards have been updated or are currently being revised by multiple professional organizations in school health. Versions of these standards are available here and here.
Sexual health is a critical component of health education
School-based sexual health education provides youth with the knowledge and skills they need to protect themselves from STIs/HIV, and unintended pregnancy.
Click here to learn more about sexual health education.
The National Sex Education Standards outline foundational knowledge and skills students need to navigate sexual development and grow into sexually healthy adults. The standards are designed to help schools focus on what is most essential for students to learn by the end of a grade level or grade span and can be used to create lessons and curricula with aligned learning objectives.18
Educator and Staff Professional Development and Training
Quality health education uses qualified teachers, connects students to health services, engages parents and community partners, and fosters positive relationships between adolescents and adults who are important to them.19-21 Successful in-service professional development programs can improve both the amount of time teachers spend on health topics and their confidence to provide health education.22-23
You can find professional development tool and resources here:
- Health Education Curriculum Analysis Tool (HECAT). This tool helps school and community leaders conduct clear, complete, and consistent analyses of health education curricula across a wide variety of topics (e.g., nutrition, tobacco, mental/emotional health).
- HECAT Webinars. A series of six videos introducing HECAT and featured health topic modules.
- HECAT Online. A free, interactive tool that allows you to work collaboratively in teams to complete projects related to curriculum analyses, comparing strengths and weaknesses of multiple curricula, and developing a scope and sequence (S&S) for health education.
- HECAT Online Instructional Guides. A series of four guides detailing how to use HECAT Online for curriculum analyses or scope and sequence development.
- Centers for Disease Control and Prevention. Health Education Curriculum Analysis Tool, 2021, Atlanta: CDC; 2021.
- Eisen M, Pallitto C, Bradner C, Bolshun N. Teen Risk-Taking: Promising Prevention Programs and Approaches. Washington, DC: Urban Institute; 2000.
- 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.
- 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.
- Coyle, K., Anderson, P., Laris, B. A., Barrett, M., Unti, T., & Baumler, E. (2021). A group randomized trial evaluating high school FLASH, a comprehensive sexual health curriculum. Journal of Adolescent Health, 68(4), 686-695.
- Goldfarb, E. S., & Lieberman, L. D. (2021). Three decades of research: The case for comprehensive sex education. Journal of Adolescent Health, 68(1), 13-27.
- Marseille, E., Mirzazadeh, A., Biggs, M. A., Miller, A. P., Horvath, H., Lightfoot, M., & Kahn, J. G. (2018). Effectiveness of school-based teen pregnancy prevention programs in the USA: A systematic review and meta-analysis. Prevention Science, 19(4), 468-489.
- Denford, S., Abraham, C., Campbell, R., & Busse, H. (2017). A comprehensive review of reviews of school-based interventions to improve sexual-health. Health psychology review, 11(1), 33-52.
- Evans, C. B., Fraser, M. W., & Cotter, K. L. (2014). The effectiveness of school-based bullying prevention programs: A systematic review. Aggression and Violent Behavior, 19(5), 532-544.
- Faggiano F, Minozzi S, Versino E, Buscemi D. Universal school-based prevention for illicit drug use. Cochrane Database Syst Rev 2014(12):CD003020
- Onrust SA, Otten R, Lammers J, Smit F. School-based programmes to reduce and prevent substance use in different age groups: What works for whom? Systematic review and meta-regression analysis. Clin Psychol Rev 2016;44:45-5
- Hodder, R. K., Freund, M., Wolfenden, L., Bowman, J., Nepal, S., Dray, J., … & Wiggers, J. (2017). Systematic review of universal school-based ‘resilience’ interventions targeting adolescent tobacco, alcohol or illicit substance use: A meta-analysis. Preventive medicine, 100, 248-268.
- Rasberry CN, Tiu GF, Kann L, et al. Health-Related Behaviors and Academic Achievement Among High School Students— United States, 2015. MMWR Morb Mortal Wkly Rep 2017;66:921–927
- Basch CE. Healthier students are better learners: high-quality, strategically planned, and effectively coordinated school health programs must be a fundamental mission of schools to help close the achievement gap. J Sch Health. 2011 Oct;81(10):650-62.
- Chin HB, Sipe TA, Elder R. The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: Two systematic reviews for the guide to community preventive services. Am J Prev Med 2012;42(3):272–94.
- Mavedzenge SN, Luecke E, Ross DA. Effective approaches for programming to reduce adolescent vulnerability to HIV infection, HIV risk, and HIV-related morbidity and mortality: A systematic review of systematic reviews. J Acquir Immune Defic Syndr 2014;66:S154–69.
- World Health Organization. Skills for health: Skills-based health education including life skills: An important component of a child-friendly/health-promoting school. World Health Organization, 2003.
- Future of Sex Education (2020). National Sex Education Standards (Second Edition).
- Murray, C. C., Sheremenko, G., Rose, I. D., Osuji, T. A., Rasberry, C. N., Lesesne, C. A., & Roberts, G. The influence of health education teacher characteristics on students’ health‐related knowledge gains. J Sch Health 2019; 89(7): 560-568.
- Centers for Disease Control and Prevention. PS18-1807 program guidance: Guidance for school-based HIV/STD prevention (component 2) recipients of PS18-1807. Atlanta, GA: U.S. Department of Health and Human Services; 2019.
- Centers for Disease Control and Prevention (2016). Characteristics of an Effective Health Education Curriculum.
- Telljohann SK, Everett SA, Durgin J, Price JH. Effects of an in-service workshop on the health teaching self-efficacy of elementary school teachers. J Sch Health. 1996;66(7):261-265.
- Clayton HB, Brener ND, Barrios LC, Jayne PE, Everett Jones S. Professional development on sexual health education is associated with coverage of sexual health topics. Pedagogy Health Promot. 2018;4(2):115-124. doi: 10.1177/2373379917718562.