School Health Education HEALTH THROUGH EDUCATION

Comprehensive School Health Education

Kolbe's Expectations

Dr. Lloyd Kolbe lines up the expectations of a school health education. These are: increased understanding about the science of individual and societal health; increased competency to make decisions about personal behaviors that influence health; increased skills required to form behaviors conducive to health; contribute to the development and maintenance of such behaviors; and enhancement of these skills to maintain and improve health of families and communities.

The existing school health education has not come to par with its function. It confronts problems, such as the failure of the home to encourage practice of health habits learned in school, ineffectiveness of instructional methods, and resistance to certain health topics by parents and the community. A more effective or responsive school health education requires a valid curriculum, qualified teachers, and consistent application of what is learned.

Increased understanding about the science of individual and societal health.

Schools are expected not only to provide high-quality instruction but also to pay attention to student health. Studies show the substantial connection between nutrition, physical activity and learning. Healthy children are definitely more prepared and capable to learn, less likely to skip school, and inclined to take advantage of educational opportunities available than those who are not healthy. Moreover, inadequate nutrition during childhood asserts harmful effects on children's learning processes and eventual productive capability in adulthood. A direct relationship has also been shown between education achievement and breakfast, physical activity and educational achievement. Breakfast enhances learning and reduces tardiness. Physical activity increases concentration; improves math, reading and writing test scores; and reduces disruptive behaviors. Growing Healthy program has shown to produce the greatest knowledge of this connection among tested students.

Increased competency to make decisions on personal behaviors that influence health. The school must be adequately aware of and deal with the student's psychological defenses and biases concerning health. These may be in the form of denial, repression, sublimation or another psychological defense mechanism. School's action may warrant problem restructuring or another way of looking at the problem. Any way it is interpreted or accepted, the problem will require emotional control, which can be in form of exercise, relaxation or suggestion. Whatever the strategy, it must address and affect the person, environment and behavior interaction in order to create an impact and achievement success. Competency before the 70s was derived from lecture or information exchange and premised on the belief that information leads to the adoption of healthy behavior. The concept of moral reasoning was introduced by Lawrence Kohlberg during that time. It focused on cognitive development, which assumes that "an individual's thinking matures according to a specific sequence." The concept consists in three levels with two stages each. The concept requires that the curricula and activities that follow them present moral dilemmas. These dilemmas assist the student clarify his reasoning, identify and adjust inconsistencies, and advance reasoning. However, it then encountered a number of problems. Learning occurs in different stages. Some parents could not share their child's learning experience. A dilemma was not clearly understood at the time. And fewer than 20% of adults mature in moral reasoning. They develop poor decisions concerning health because of the lack of appropriate value systems to develop health-seeking behaviors. Problem-solving approaches became a fad in the 80s. At this time, group activities were used to identify problems and guide the process of making logical decisions. Rodney Allen introduced synthesis, a 9-step model of decision-making. However, older and manipulative children, time demands and conflicting parental perspectives presented problems. In the 90s, the social learning theory was introduced. It states that behavior is learned in social situations proactively and repetitiously. Decision-making follows the same pattern. The present curriculum theory is drawn from administrative, practitioner and academic or researcher perspectives. An appropriate example is the Health Belief Model with perceived seriousness, susceptibility, benefits and barriers as key concepts.

Increased skills required to form behaviors conducive to health. The school or a health educator can encourage students to form healthful behaviors by using the Social Cognitive Theory, which leans on vicarious learning as a key concept. It attends to the behavior, retains it, reproduces it and motivates the person to engage in it. This Theory needs the modeling and reinforcing of skills to encourage or enable the adoption of healthy behaviors, specific training in these skills and the inclusion of the essentials of behavior change. The Growing Healthy program illustrates these.

Contribute to the development and maintenance of these behaviors. The Complimentary or Synergistic Theory enhances the development and maintenance of these healthful behaviors. It transmits consistent messages, which multiply channels. It provides the opportunity to reinforce health messages. It allows role modeling of these messages. It enables team approach, provides the opportunity to practice the health behaviors and is cost-effective. Examples are the California Project LEAN, Food on the Run Program and CATCH.

Enhancement of skills to maintain and improve the health of families and communities. The school, the community and families should be jointly involved. The joint involvement can lead to an inter-agency school health coalition, the identification of common goals, community initiatives for implementation in schools. Schools, which implement intense physical activity programs, see the positive effects of these programs on students' academic achievement....

One of the best ways to prevent of disease is, therefore, for schools to foster policies and implement programs that encourage healthy behaviors for lifetime maintenance. The Growing Healthy program is one such program.
I. School Health Education -- the 10 content areas are community health, consumer health, environmental health, personal health and fitness, family life education, nutrition and healthy eating, disease prevention and control, safety and injury prevention, prevention of substance use and abuse, and growth and development.

Health education is a merger of learning experiences aimed at facilitating voluntary actions that enhance health (Green and Kreuter, 1991). It is also defined as a process of continuum of learning. This process enables individuals in every social structure to voluntary make decisions, change social conditions in health-conducive ways.

These content areas must be merged with the skills set forth in the expected learning results. The National Health Education lists 7 standards for these learning results. Under Standard 1, students will understand concepts of health promotion and disease prevention. Under Standard 2, students will be able to access valid health information and health-promoting products and services. Under Standard 3, students will practice health-enhancing behaviors and reduce health risks. Under Standard 4, students will analyze the influence of culture, media, technology and other factors involved in health. Under Standard 5, students will be able to use interpersonal communication skills to enhance health. Under Standard 6, students will be able to use goal-setting and decision-making skills. And under Standard 7, students will be able to advocate for personal, family and community health. Involved in health promotion are intrapersonal, interpersonal, institutional, community factors and public policy.

These outcomes or results can be achieved through the comprehensive school health program or CSH. The components of this program are a comprehensive school health education, a healthy school environment, school health services, school food services, school counseling and psychological services, health promotion for faculty and staff, school and community initiatives and physical education. The CSHE is a documented, planned and sequential instruction format, consisting of a range of health topics. These include nutrition and fitness; consumer and environmental health; tobacco, alcohol and other regulated substances; personal health; family health; and injury prevention and control. It is undertaken by professionally trained educators, who teach essential life skills, at a prescribed duration, usually 45-50 hours. It involves parents and the community and is subjected to periodic evaluation and updating. It is constructed according to national, health and local goals. National goals are delineated by the Healthy People Program, the Goals 2000 Program, and National Standards for Health Education.

Among the issues confronted by the CSHE evolve around curriculum development and instruction, coalition among schools and communities, teacher training, and policy and resources.

Health education is taught differently from academics. Cognitive learning is secondary. It requires another method or set of methods. It is concerned with socio-cultural impacts and varying as well as conflicting sources of influence and information. Facts and established beliefs quickly become obsolete. And delayed responses make clear-cut evaluation difficult. Many barriers stand on the way to developing and maintaining learned behavior. Large concepts must be reduced to meaningful specifics in order to be understood. There too is an overall lack of interest and value in health. It is also wide in scope and content.

Eunice Tyler lists the learner, the community and recommendations by specialists as the basic inputs into health education curriculum planning. Its critical components are critical thinking, affective development and personal and social skills. Critical thinking skills consist of knowledge, comprehension, application and a higher-order type of thinking skills. It covers affective development through values and attitudes taught by Kohlberg as well as personal and social skills. These are communication through assertiveness, goal-setting, decision-making, stress-coping skills and conflict resolution. Academic skills must be incorporated into it. These include reading, mathematics, social studies, ethics,…