Health Curriculum Framework
Building Resilience Through Comprehensive Health
The Guiding Principles of Comprehensive Health Education
The following principles guide teaching and learning in comprehensive health education.
- Comprehensive health education fosters student resilience through the coordinated teaching of health, family and consumer sciences, and physical education.
- Interdisciplinary instruction enriches the learning of fundamental health concepts and practices.
- Student concerns, interests, views, and ideas are central to active learning and to the classroom assessment of comprehensive health education.
- Comprehensive health education requires collaboration and partnerships among all components of the comprehensive school health program.
- Comprehensive health education acknowledges and respects similarities as well as differences among people.
- Comprehensive, sequential health education at every level, preschool through high school, is essential to lifelong learning and health for all students.
Comprehensive health education fosters student resilience through the coordinated teaching of health, family and consumer sciences, and physical education.
Comprehensive health education includes a range of health education content areas. It also incorporates substantial portions of the disciplines of family and consumer sciences (home economics) and physical education. These three subjects are interdependent.
How these disciplines are taught, how they are integrated, and the ways in which their teachers collaborate, will necessarily vary across school districts because of scheduling, staffing, and educational priorities at the local level.
The field of Family and Consumer Sciences (Home Economics) is concerned with the strength and vitality of families, and the role of individuals in the workplace and as consumers of goods and services. Education in this discipline teaches knowledge and life management skills related to:
The discipline of Physical Education addresses cognitive, social, and physical development. Physical Education programs are designed to help students:
- human growth and development
- parenting, child development, and family living
- personal and family health and safety
- household management
- careers and employment
- consumer awareness
- using technology
- textiles and apparel
- resource and environmental management
- develop concepts of body and spatial awareness
- acquire and refine a variety of manipulative, locomotor, and nonlocomotor movement skills
- develop competence in specific movement forms
- demonstrate strategies, teamwork, and fair play in sports and cooperative games
- design and maintain personal fitness programs
- understand and value the benefits of regular physical activity
- link movement activities with opportunities for self-expression and appreciation of diverse cultures
- exhibit a physically active lifestyle
Health Education provides a foundation in public health and medical knowledge and inquiry into how individuals and societies acquire and/or change their health-related knowledge, attitudes, and behaviors. Within the broad range of health content areas (see Figure 2, page 21), students learn much more than factual information. They develop skills in finding and evaluating information and resources; making decisions and setting goals; and acting in ways that promote their own health, and the health of others.
Ideally, the relationship among these three interdependent disciplines is dynamic, interactive, and mutually supportive. Each area brings its specific content and perspective; together they develop students' knowledge, skills, and habits of mind and body that are essential to managing healthy lives.
Interdisciplinary instruction enriches the learning of fundamental health concepts and practices.
Comprehensive health education is inherently interdisciplinary. It encompasses health education, physical education, and family and consumer sciences. Collaboration just among these three fields can present creative challenges and substantial rewards.
Reflections from a Massachusetts Study Group
"We were interested in the interdisciplinary approach suggested in this chapter. As a result of reading this framework we decided to approach the family and consumer sciences department and the physical education department. We are already working with the counseling department and the food services department. Together we hope to do some interdisciplinary planning in order to implement a comprehensive health framework."
Chicopee Study Group
Comprehensive health education is also related to other disciplines in many ways. For example, health information that is based on scientific and quantitative research is clearly linked to math and science and technology. When it focuses on the quality of human relationships and personal well-being, it is connected to social studies. Because it is concerned with practicing movement and behavioral skills, it has natural affinities with the performing arts. Communication skills, such as active listening, reflecting, and accurate reporting, draw heavily on English language arts. Conversations in world languages classrooms often include discussions of food, families, and household management, vocabulary of directional movement (up, down, under, between, near, outside), and physical activities and sports.
Reflections from a Massachusetts Study Group
"Our vocational high school students, with the support of staff members, organize the clean-up of downtown, as well as beautifying our school grounds. The culinary arts curriculum devotes several units to health, including safety, personal hygiene, sanitation, food-borne illnesses, menu planning, and nutrition. Our newest endeavor is an attempt to bridge the gap between our students and the elderly by inviting several senior citizens to lunch at our student-operated restaurant each month. They are accompanied by students and welcomed to tour our facilities. Hopefully this will build strength and trust in our community. Health CAN be taught and learned in many different classrooms and disciplines."
Lowell Vocational Technical School Study Group
Student concerns, interests, views, and ideas are central to active learning and to the classroom assessment of comprehensive health education.
When comprehensive health instruction responds to student concerns and perceptions of risks, it teaches students to inquire, reason, and solve problems. By basing instruction on an accurate assessment of the range and levels of student knowledge, and building curriculum around student questions, health educators equip students to face very real challenges in their everyday lives. Scare stories and blanket admonitions about "responsibility" are insufficient to help students to assess risks rationally or make health-enhancing decisions.
Using Students' Questions and Concerns In Planning Health Lessons
Listening carefully to students' questions can tell us a great deal about their level of understanding. Questions can reflect myths and incorrect information as well as a student's individual struggle to make sense out of competing claims. Frequently it is necessary to rephrase a question in order to clarify its intent. Discussion needs to validate students' efforts to make sense of previously unexamined aspects of their lives.
Student surveys can help educators identify what students already know about health-related topics, and what further information and skills students feel they need at various levels. When Massachusetts high school students were surveyed about sexuality education, a significant percentage requested that sexuality education start earlier in the elementary grades and extend through senior year. These students felt that they needed to learn about sexuality in different ways at various grade levels as their general understanding broadened and their questions evolved.7
At all age levels, students need help in dealing with some degree of peer pressure or fears of what others will think of them if they voice their questions and concerns. Teachers can arrange for students to use written questions and to follow ground rules for discussion that guarantee confidentiality. For example, adolescents who are experiencing anxiety or confusion concerning sexual orientation need techniques that ensure anonymity.
When classroom assessment evaluates complex, active learning, it serves to improve instruction. Teacher observations, videotapes, role plays, group presentations, student portfolios, and community projects are some of the assessment strategies that give teachers, students, families, and communities a full understanding of learning in progress.
A Classroom Snapshot
Early one spring morning, waiting for health class to begin, Pedro remarked, "Just think, next year we'll be in eighth grade, and we'll be the big kids here."
"Yeah, and we can boss around all the little kids." Jack grinned at the prospect. "Remember how scared we used to be of the eighth graders? And this school seemed so huge."
"My sister was in that class," added Mario, "so I knew some of them -- but they hardly ever said anything to me in school."
Mr. Chang postponed his planned discussion of peer pressure and alcohol use, and instead asked, "What would have made this place feel more welcoming when you first came?" After a short pause, there was a rush of answers.
"Well, I'd never been inside the building before. I didn't know what to expect."
"Everyone else seemed to know people. The kids from my elementary school were all in other classes, and I felt lost."
"I didn't dare use the bathroom, because I'd heard kids did drugs in there.
"I didn't even know where the bathroom was, and I was too scared to ask anyone."
As the class came alive with memories, suggestions began to emerge: The incoming sixth graders should have a tour of the building in the summer before school starts. Or in the spring, when students and teachers are there. Perhaps they could meet some of the teachers and students. The older students should remember how they felt as sixth graders, and be friendly and helpful.
"That means us. Maybe instead of acting like big shots, we ought to `adopt' a younger kid and try to help them out..."
"It's not just the sixth graders. That's how I felt when I moved here in the middle of the year."
From this impromptu discussion, the health class developed the idea for a peer helper program for all new students. The class researched and prepared written materials which they presented to the student council. The program was implemented with an expanded mission to make the school more welcoming to everyone. Fueled by their shared memories of uncomfortable experiences, the students became advocates for those who would follow them.
Comprehensive health education requires collaboration and partnerships among all components of the comprehensive school health program.
Education in all subjects, including health, can be most effective when health is an important priority throughout the school. Health and education are closely interrelated; students who are unhealthy or troubled are students whose learning may not be optimal. In fostering academic achievement and resilience, classroom instruction is supported by all components of a comprehensive school health program (see Figure 1, next page):
- Comprehensive Health Education
- Health Education
- Physical Education
- Family and Consumer Sciences Education
- Food and Nutrition Services
- Health Services
- Psychological and Counseling Services
- Safe and Healthful School Environment
- Health Promotion for Staff
- Family and Community Involvement
When these components are linked in a planned, coherent, mutually supported system, they reinforce health knowledge and skills as well as attitudes and behaviors that help students stay healthy.
Reflections from a Massachusetts Study Group
"Our school has recognized that building character and teaching responsibility to our students is essential to their educational and life careers. The emphasis on these areas can only have a positive impact on all learning within our school. The effective building of resilience must begin with the cooperation of all staff members within the school, not just one particular program. Integrating the health program into all areas of the curriculum -- and involving food services personnel in teaching nutrition, guidance staff to teach conflict resolution, and the nurse to teach first aid and other areas -- will promote good will and collaboration throughout the school, and improve children's education."
Freetown Elementary Study Group
Health services, food and nutrition services, and psychological and counseling services involve families in the life of the school, helping them to support students' academic achievement and health.
A Classroom Snapshot
"At our family forums, students are amazed to learn that their parents dealt with peer pressure and risk behaviors when they were young. Parents develop new respect for the challenges their sons and daughters face in assessing risks and trying to stay focused on achievement in school. This has become one of our most popular programs."
Boston Parent Coordinator
A safe and healthful school environment supports successful teaching and learning. Health promotion programs for staff enable teachers and other staff members to recognize the importance of lifelong health learning, and to model healthy behaviors for students. When instruction and services work together they can build alliances with families and the community that improve educational outcomes for all students. Working together, families, schools, and the community can convey a message to every student: We care. Your success is important to us. When students aspire to high levels of educational achievement, perceive there are opportunities for them to excel, and have a solid knowledge of health, they are more likely to make health-enhancing decisions and avoid risky behaviors.8
The Comer Model
Working with colleagues at the Yale Child Development Center, Dr. James P. Comer has developed a public health model for schools that links health services with aspects of comprehensive health instruction in order to build partnerships among local schools and families. The School Development Program links the principal, guidance counselors, comprehensive health educators, and classroom teachers with parents as team members. These teams work on several fronts to promote a supportive school climate that helps students connect their lives at home with their experiences in the classroom:
- A governance team advises the principal on solving problems and improving the quality of relationships throughout the school.
- A mental health team works with teachers and parents to help them see each child's academic achievements and potential in the context of his or her overall emotional and social development.
- Parents identify social and life management skills that they feel their children will need to succeed in society. Some of these involve specific knowledge such as knowing how to balance a checkbook, write invitations, or respond to a person with cancer. Others involve practicing social skills such as negotiating conflict or working cooperatively. These skills are then taught by a team of parents and teachers as part of the curriculum.9
Comprehensive health education teaches students to acknowledge and respect similarities as well as differences among people.
This framework encourages the development of peer programs whose leaders represent a cross-section of the student population. It supports learning about similarities and differences in our communities, affirming our own backgrounds and beliefs without having to justify them or argue about which is right or best. It promotes student analysis of the effects of prejudice and bias on personal, family, and community health. It provides opportunities for students to join with their families, peers, school staff, and community leaders to build inclusive schools and communities.
Comprehensive health education includes knowledge of the contributions that men and women of various groups have made and continue to make to health research, public health, environmental health, and medical science. The oath attributed to Hippocrates and still taken by physicians today is from a body of medical texts written and collected in the fifth through third centuries BCE in Alexandria, Egypt. Treatment methods such as acupuncture and exercise and wellness systems such as yoga and tai chi, which have been in use in Asian cultures for many centuries, are now beginning to receive serious attention in Western medicine. In addition, new medicines are being derived from plant species used in traditional cultures in various parts of the world.
A Classroom Snapshot
Ms. Collins observes the following conversation in her first grade classroom.
"I live with my mom," says Patricia.
"Don't you have a daddy," asks Trudy.
"He doesn't live with us," Patricia responds.
"Then you don't have a real family," Trudy tells her.
"Uh-huh, yes I do," replies Patricia.
"Not if your daddy doesn't live with you," rejoins Trudy.
In response, Ms. Collins develops a unit on families: they come in many sizes, shapes, and types. Families may have different groupings of people, but family members can still share common functions, such as caring, teaching, affirming, comforting, listening, feeding, cleaning, earning, celebrating milestones, and sharing other responsibilities.
Comprehensive, sequential health education at every level, preschool through high school, is essential to lifelong learning and health for all students.
In the past, comprehensive health education was sometimes limited to piecemeal instruction on isolated topics -- a single lesson on dental hygiene in the second grade; a few sessions on family life and sexuality (sometimes only for girls) in the middle school; a school-wide assembly on HIV/AIDS prevention in high school; perhaps even a semester of health education, physical education, or family and consumer sciences inserted into the schedule. Such a scattered approach fails to capitalize on the interrelationships between all aspects of health.
Early Childhood Comprehensive Health Education
"It is critical that health education begin in the early years, PreK-1. Young children learn through play the foundations of resilience: positive relationships with peers and adults; perseverance; conflict resolution; acceptance of differences; and self-esteem."
Massachusetts Early Childhood Advisory Council
Research shows that instructional time in comprehensive health needs to be regular and of sufficient duration to have a significant positive effect on attitudes and behaviors. Fundamental health knowledge and skills need to be taught in prekindergarten and early elementary years, and reinforced and expanded regularly in subsequent grades. A planned, sequential curriculum addresses a variety of topics with increasing degrees of complexity appropriate to students' developmental levels. Such a program ensures thorough, balanced coverage of health subject areas, and is readily adapted to incorporate emerging health issues.
Through comprehensive health education, schools teach students to understand and demonstrate the importance of healthful behavior for living active, productive, rewarding lives as individuals, family members, and citizens, contributing to safe and vital communities.