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Tough New Issues Refocus Health Education

Technology spurs the need for new or revised curricula in schools.

From dating violence to sexting and social networking, districts are struggling to address a number of sensitive and relatively new health education issues that are aggravated by students' increasing access to computers, cell phones and other digital devices. Through new or revised curricula, administrators are attempting to deal with these and other issues. Their efforts sometimes become contentious when parents object to language or materials used in a curriculum and even threaten lawsuits to force changes.

Malcolm Goldsmith, executive director of the American Association for Health Education, says technology represents the latest significant change in health education, which grew out of the "hygiene movement" 50 years ago, when "there was a lot of emphasis on taking care of your body."

In the 1980s and '90s, while dedicated health teachers continued to instruct students on nutrition and personal health, there also was an increasing focus on drug education and the beginning of sex education.

In the last 10 years, Goldsmith continues, the focus has been on health problems linked to the six critical types of adolescent health behavior identified by the U.S. Centers for Disease Control and Prevention— alcohol and drug use, injury and violence, tobacco use, nutrition, physical activity and sexual risk behaviors. Today, he says, suicide and mental health problems are growing, often stimulated by technology's impact.

"Cyberbullying and sexting can't happen without technology," says Susan Wooley, who just retired at the end of 2010 as executive director of the American School Health Association. "I don't think they existed 10 years ago and they were not big issues even five years ago, but they are now. The kids know more about them than the educators do, and the educators are trying to catch up."

Wooley says parents as well as school districts need to take a stronger role in addressing the issues their children face. In addition to talking about the issues with their children, they should take action when they become aware of incidents like cyberbullying. They should contact the parents of offenders to discuss the problem, reach out to social network providers like Facebook, and talk to school teachers and administrators about ways schools could provide education and counseling to students about potential consequences of this type of behavior, Wooley says.

Curriculum Changes

A revised health education curriculum that the Helena (Mont.) Public Schools adopted in October 2010 requires instruction in all grades to underscore district policy against any form of bullying or other harassment or intimidation of students. "We inserted the policy right into the curriculum," says Superintendent Bruce K. Messinger. But when parents objected to some language proposed for the curriculum—at least one parent threatened to sue the district—the language was changed.

McCollum High School students in the Harlandale Independent School District in Texas put on a dance performance. The district promotes healthy eating and attitudes as part of its curriculum.

For example, proposed instructional language in the seventh- grade curriculum discussing sexual assault and rape that included the phrase "penetration of the vagina, mouth or anus" was changed to "Montana law defines rape as sexual intercourse without consent." In North Carolina, a new "Comprehensive Health Education Program" adopted last summer by the Chapel Hill-Carrboro City Schools mandates violence prevention and nutrition instruction starting in middle school.

The district is calling on community resources for support, including the Family Violence Prevention Center of Orange County (N.C.) and the Orange County Rape Crisis Center, which send professionals trained in social work or related fields to talk to middle school students. For 45-minute classroom sessions on three consecutive days, they teach how to keep oneself safe from relationship violence and sexual bullying, reports Stephanie Willis, health coordinator for the school district. The district's regular health teachers sit in on the classroom sessions.

The Anchorage (Alaska) School District supplements its health curriculum with a teenage health teaching module, "Aggressors, Victims, and Bystanders," which the district started using five years ago and which is produced by the nonprofit Education Development Center. Prior to using this module, Anchorage students were involved in several harassment incidents. "We were looking for a program to address the bullying and harassment that we were seeing," says Jan Davis, who teaches and coordinates social and emotional learning support in the district's middle schools. "We knew we needed something."

Founding members of Redefining Beautiful, a student club meant to empower girls to resist stereotypes based on appearance, pose at Colleyville Heritage High School in Colleyville, Texas.

The module focuses on teaching students to help others, be compassionate toward them and report incidents of bullying if they become aware of them. "We have been able to stop a lot of incidents because kids reported them," Davis says.

Anchorage uses the module as a supplement to its basic middle school health education curriculum, which for eighth graders covers diseases, body functions, mental health, drugs, alcohol and sex education in 45-minute classes daily for a semester. Science and physical education teachers, some certified in health education, instruct the class.

In the first revision of its health instruction since the 1980s, East Lyme (Conn.) Public Schools Board of Education adopted last fall a new "Health and Balanced Living" curriculum that combines health and physical education, previously separate programs. Subjects include alcohol and other drugs, community and environmental health, mental health, personal and consumer health, nutrition, family life and sexuality, tobacco and physical activity. All subjects must be covered at every grade level, and issues like cyberbullying and "whatever else is current" are addressed in the units where they fit, says Karen Costello, the district's administrator for program improvement.

Lessons Learned

At least one district is using lessons learned from the Holocaust to teach students to tolerate other students who are gay and often the victims of bullying. Trips to the Museum of Tolerance in Los Angeles are part of the middle school curriculum in the Tehachapi (Calif.) Unified School District. Through interactive exhibits, special events and customized programs for youths and adults, the museum, which opened in 1993, challenges visitors to take responsibility for positive change. The museum visits were part of the Tehachapi district's curriculum even before 13-year-old Seth Walsh, a student at the district's Jacobsen Middle School, hanged himself last September after being bullied by students because he was gay.

Childhood Obesity

Wooley says childhood obesity, another troubling issue, is impacted by technology, whereby students spend too much time sitting in front of televisions, computers and video games and not enough time engaged in outdoor activities. A health maintenance and enhancement section of the Helena district's revised curriculum addresses obesity and related issues by focusing, for example, on "knowledge and skills to manage diet and exercise for a healthy life" in seventh grade.

Students at North Plainfield High School in New Jersey are rehearsing a play, "Don't U Luv Me?" which explores violence in teenage dating, which is among the health topics in districts.

"With so many good Mexican restaurants, eating is part of the culture here," says Gina Castro, facilitator of Coordinated Approach to Child Health (CATCH) for the Harkandale (Texas) Independent School District, one of 15 districts in San Antonio. But eating also contributes to an obesity problem that the district tries to combat through its curriculum, which requires middle school students to get at least 30 minutes of physical ed five days a week. In a one-hour health class for one semester, high school students learn about nutrition and healthy eating.

Getting Results

In many districts, says Goldsmith, the health education curriculum is outdated because it is not a priority. It has become a "sacrificial lamb," he explains, taking a back seat with other subject areas like music and the arts to a national commitment to improve academic performance in reading, mathematics and science. In other districts that have updated their curricula, some administrators say it isn't easy to achieve positive results. "It's difficult to create a curriculum that appeases everyone," concludes Messinger, "and I don't know that we will, but we're trying to be sensitive to these issues."

Alan Dessoff is a contributing writer for District Administration.