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1998 Massachusetts School Health Education Profile Report

Conclusions

The 1998 Massachusetts School Health Education Profile documents the status of many important aspects of school health education across the Commonwealth; it also makes possible the monitoring of changes in health education since 1994. According to the results of the 1998 SHEP, Massachusetts has made significant progress in most areas of school health education, though some areas of concern still remain.

Substantial increases have occurred in school health education over the past few years. In 1998, secondary schools on average report requiring two health education courses, as contrasted with an average of slightly over one required course four years previously. In addition, since 1994, requirements for health education have risen steadily at every grade level. Both of these are positive developments, indicating an increasing attention to health education in Massachusetts schools. It is important to maintain these gains, but also to work towards ensuring that all students receive developmentally appropriate health education in their final years of high school.

Most important prevention topics are covered in health education classes, and the development of health-related skills is increasingly emphasized. All but a very few secondary schools teach information about tobacco, alcohol and drug use prevention, HIV and STD prevention, dietary behaviors and nutrition, conflict resolution and violence prevention, physical activity, fitness, and other key health topics. Additionally, more health education teachers in 1998 than in 1996 report that they structure their instruction to help adolescents learn the skills they need to avoid health-related risks and to develop health-enhancing lifestyles. The broad coverage of key prevention topics, and especially the increase in teaching young people health-related skills are both very positive developments. It is important that youth be taught these topics and skills in a way that enables them to personalize health education messages and apply that education to their own lives.

Requirements for HIV/AIDS prevention education, which had risen from 1994 to 1996, dropped from 1996 to 1998 in every grade but 10th. In 7th and 8th grade, this decline was statistically significant. Although the Massachusetts Board of Education's Policy on HIV/AIDS Prevention Education recommends that such instruction should be provided for every student at every grade level and should include information on "the value of both sexual abstinence and the use of condoms as disease prevention methods," it is clear that this policy is not uniformly followed. Inconsistent instruction about condoms and the lower levels of HIV/AIDS prevention education in the final grades of high school are especially troublesome in light of findings that by the end of 11th grade half of all students had become sexually active. Both of these issues need to be confronted by schools and health educators in order to ensure that all adolescents are receiving developmentally appropriate HIV/AIDS prevention education that is reinforced throughout their school years.

Health education in Massachusetts schools is becoming more standardized. Increasingly, health teachers report that they use school, district, and state curriculum frameworks to plan their health courses. There has also been a significant increase in the use of commercial health education curricula, which are more likely than locally-developed curricula to have been widely tested and formally evaluated for effectiveness. The new Massachusetts Comprehensive Health Curriculum Framework should be very useful in helping health educators develop health education programs that are comprehensive, sequential, developmentally-appropriate, and also aligned with the concerns and issues of local communities.

Health education in Massachusetts schools is less frequently being coordinated with other disciplines or with other constituencies than was true a few years ago. Although national recommendations for comprehensive school health programs suggest that health education is most effective when coordinated with other subjects and with community groups, there was less cross-disciplinary collaboration and less coordination with local law enforcement and with PTA/PTO's in 1998 than in 1996. This recent trend toward the isolation of health education from other disciplines and from outside input is of concern, and indicates that health teachers need to renew their efforts to make connections and to coordinate programs both with other teachers and with community members concerned about adolescent health.

Most health education teachers are receiving in service training on health-related topics, and are seeking more. Unfortunately, school support for such professional development, which had risen from 1994 to 1996, declined significantly from 1996 to 1998. Keeping up with new developments in the field is essential for health teachers, as it is for all educators. School administrators should be urged to support such ongoing staff development by offering in service training, providing substitute teachers when necessary, and covering the costs of professional development.

Parents are largely supportive of health education. Principals report far more positive than negative feedback about their school's health education, and teachers are far more likely to report expanded rather than restricted topic coverage due to parental feedback. Even though most schools have a policy permitting parents to exempt children from all or part of health education, very few parents actually do so. Both health educators and school administrators need to be aware of the broad support that school health education enjoys in Massachusetts; such awareness can help put in perspective the rare opposition to some aspects of health education. Keeping parents informed about school health education and finding ways to promote active involvement of parents and other community members in health education programs and activities continue to be important ways of fostering parent and community support.

Virtually all schools have adopted some basic policies regarding school health and safety issues. Written policies on HIV/AIDS, school safety and weapons possession, alcohol and drug use and possession, sexual harassment, and harassment due to race or ethnicity were in place in over 95% of all secondary schools and seem to be written with appropriate levels of specificity. Policies regarding general bullying, harassment of gay and lesbian students, and adult attendance at school-related events are less common. Also, many schools have not provided recent staff training on the policies they do have, making strong and uniform enforcement of the policies problematic. Creating and maintaining a school community that is safe for all students and staff is a major responsibility of school administrators. Strong policies and school-wide awareness of and enforcement of those policies are essential parts of that task.

Most schools have programs in place that support health, safety, and achievement by monitoring the progress of at-risk students; by providing academic tutoring, non-academic counseling, and various kinds of support groups; and by fostering links between youth and the larger community through community service learning or opportunities for volunteer work. Although much health education occurs in the context of classroom instruction, other supportive school programs and structures such as these also play a critical part in helping youth develop healthy and productive lives.

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