Current Trends The Effectiveness of School Health Education
The School Health Education Evaluation (SHEE), conducted in
collaboration with CDC, from 1982 through 1984, suggests that
exposure
to health education curricula in schools can result in substantial
changes in students' knowledge, attitude, and self-reported
practices.
More than 30,000 fourth- through seventh-grade students
representing 1,071 classrooms in 20 states were included in an
experimental study comparing the effectiveness of four curricula.
Details of the statistical analyses are described elsewhere (2).
Overall, children exposed to health education showed increased
knowledge, healthier attitudes, and better health skills and
practices
than those who did not receive health education. Comparisons of
the
curricula showed each to be most effective in the areas emphasized
by
developers and believed by teachers to be most important.
One of the four curricula evaluated, the School Health
Curriculum
Project (SHCP, now called "Growing Healthy"), may delay the onset
of
smoking among youth. In the fourth through the sixth grades, where
the prevalence of smoking is low, the rate of self-reported smoking
did not differ between classes that received the curriculum and
classes that did not. However, among seventh graders, the data
showed
a 55% increase in smoking (from 8% to 13%) among students who did
not
participate in SHCP, compared with a 24% increase (from 6% to 8%)
among students who did (1).
The amount of exposure time to the curricula needed to produce
change can be seen in Figure 1. "Effect size" reflects the
educational importance (vs. mere statistical significance) of
levels
reached (3,4). Large effects on specific program knowledge were
achieved in relatively few classroom hours, while more than 50
hours
were required to achieve large effects in general knowledge.
Medium
effects for self-reported practices were first achieved within 30
hours of instruction, but 50 hours were needed to reach a stable
level. Only small effects on attitudes were demonstrated, even
after
50 hours of instruction.
Reported by DB Connell, RR Turner, Abt Associates, Inc, Cambridge,
Massachusetts; EF Mason, Morehouse School of Medicine, Atlanta,
Georgia; Office of Disease Prevention and Health Promotion, Office
of
the Assistant Secretary for Health; Office of Program Planning and
Evaluation, Office of the Director, Behavioral Epidemiology and
Evaluation Br, Div of Health Education, Center for Health Promotion
and Education, CDC.
Editorial Note
Editorial Note: The SHEE has provided evidence that school health
education curricula can effect changes in health-related knowledge,
practices, and attitudes, and that such changes increase with
amount
of instruction. The potential impact of these changes is large.
For
example, the data from the SHEE suggest that in 1984, if all
students
in U.S. schools had been exposed to the SHCP, 146,000 students
would
not have begun to smoke in the seventh grade (Figure 2).
Since nearly one-third (67) of the 1990 Objectives for the
Nation
may be influenced directly in the school setting, use of health
education curricula in schools may substantially contribute to the
nation's health. The SHEE "demonstrates that school health
education
is an effective means of helping children improve their health
knowledge and develop healthy attitudes" and "can decrease the
likelihood that children will adopt behavior that is hazardous to
health, such as cigarette smoking" (5). Detailed information
regarding
the specific and general effects of the various curricula
evaluated--as well as the factors affecting their adoption, use,
and
effectiveness--has been published (2).
References
Christenson GM, Gold RS, Katz M, Kreuter MW. Preface. J
School
Health 1985;55:295-6.
J School Health 1985;55.
Walberg HJ. Improving the productivity of America's schools.
Educational Leadership 1984;41:19-27.
Stebbins L, St.Pierre R, Proper E, Anderson R, Cerva T.
Education
as experimentation: final report of the national follow
through
evaluation. Abt Associates Inc, 1977.
Mason JO, McGinnis JM. The role of school health. J School
Health 1985;55:299.
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