National Health Education Research Articles

National Health Education Standards: Model Guidance for Curriculum and Instruction (Third Edition).

Since the 1990s, national standards have been developed in K-12 subject areas. National standards in health education were first released in 1995 with a second set released in 2007. A third edition, the National Health Education Standards: Model Guidance for Curriculum and Instruction was developed in 2022 under the auspices of the National Consensus for School Health Education. The purpose of this article is to present an overview of the third edition including descriptions of the development process;the 8 standards and aligned performance expectations; considerations related to the translation, dissemination, and implementation of the standards; and projections for potential impact regarding teaching and student outcomes. To develop new standards, the National Consensus formed 3 groups: the Management, Development, and Expert Review Groups. These groups employed an iterative process that included the development of 3 drafts of the standards before finalization. This process included a review of each draft by the 3 groups. The second draft included additional qualitative feedback from over 500 school health education leaders, practitioners, and stakeholders. The third edition includes 8 standards with aligned performance expectations. A description and rationale are provided for each standard along with standard-specific teaching guidance. The third edition of the National Standards for School Health Education provides guidance to state departments of education and local schools in the development and implementation of health instruction that promotes meaningful learning to guide students in the promotion of their own health and the health of others.

Concluding a Health Education Curriculum With a Decision-Making Lesson

There are numerous ways a health educator can conclude a unit of instruction to demonstrate student learning. One approach is to utilize a national health education standard to reflect upon and tie units together at the end of the curriculum. The lesson presented in this article was designed to illustrate this methodology and add to the health educator’s skillset, pedological design options, and curricular flexibility.

Experimental Study on the Establishment of Sports Fat Reduction Events for College Students under the Healthy Background

With the continuous increase in the obesity rate among college students, exploring effective strategies for weight loss has become particularly urgent. This article conducts a systematic theoretical analysis and experimental research on the obesity problem among college students in a national health context, deeply analyzing the current health status of college students and elaborating on the negative impacts of obesity on students. By summarizing and analyzing the characteristics of different types of weight loss events, the positive role of exercise in improving students' physical health is highlighted. This study designs and implements a series of exercise weight loss events, using scientific research methods, and systematically analyzes the data collected during the experimental process. The research results show that targeted exercise weight loss events can effectively promote student weight loss, as well as improve their health awareness and quality of life. This article has important theoretical and practical significance for college national health education and weight loss interventions, and plays a positive role in promoting student health.

Take Health Lessons to the Gym — Part II

This is part II of a two-part series on integrating a physical activity component in delivering health lessons to elementary and middle school students. The purpose of this series is to illustrate how health content can be implemented with hands-on activities, physical experiments, visual illustrations that are associated with a specific lesson focus, or physical tasks that require students to repeatedly practice memory recall. Two physical activities in the following five health education topics are provided in this article: (1) alcohol, tobacco and other drugs; (2) communicable and chronic diseases; (3) consumer and community health; (4) environmental health; and (5) injury prevention and safety. Corresponding National Health Education Standards and twenty-first-century skills for each activity are also provided. Similar to part I of the series, a few of the designs can be implemented with a different lesson focus or health topic. Examples are discussed at the end of the article.

The Coalition of National Health Education Organizations: Recent Advances to Strengthen the Health Education Profession.

The Coalition of National Health Education Organizations (CNHEO) has existed since 1972, with a mission of bringing together national and international health education organizations who serve within the United States to seek joint actions in support of the health education profession. Much success and collaboration have occurred over the last 50 years, including developing and implementing the 2018-2025 strategic plan. The nine member organizations of the Coalition paused to review individual and collaborative work in addressing shared goals and objectives around policy and mandates, preparation and professional development, credentialing, identity and value of health education, health education workforce and diversity, and research and practice. Findings of this mid-progress strategic plan review suggest that great value is provided to the profession via the collaborative work of organizations (sharing of advocacy alerts and work, supporting training and certification efforts, etc.), but areas for improvement exist (more joint policy statements, better study and support for the profession, etc.). This article outlines important Coalition history for the profession, describes goal and objective accomplishments related to the CNHEO 2018-2025 strategic plan, and makes suggestions for future improvement designed to affect the health of the public and the health education profession.

Evolving Disparities in Cannabis Use Among Youth by Demographics and Tobacco and Alcohol Use in the U.S.: 2013–2021

IntroductionThe current study investigated the prevalence of past 30-day cannabis use among US youth by cigarette use, alcohol use, demographics and state-of-residence cannabis legal status in 2021, and examined whether changes in prevalence were modified by these factors from 2013 to 2021. MethodsData were drawn from the 24 states that collected cannabis use data participating in the Youth Risk Behavior Surveillance System (YRBSS) from 2013-2021. Logistic regression analyses estimated past 30-day cannabis prevalence in 2021 and produced adjusted odds ratios (AOR) by current cigarette, alcohol, state-of-residence cannabis legal status. The same method was used with year as the exposure, adjusting for sex, race and ethnicity, to assess trends in prevalence from 2013 to 2021. ResultsIn 2021, cannabis use was more common among female (16.75% vs. 13.83%, AOR=1.26 (95% CI: 1.16, 1.37)), Non-Hispanic (NH) Black and Hispanic youth relative to NH White youth (17.19%, 16.14% vs. 14.60%; AOR=1.25 (95% CI: 1.12, 1.39); AOR=1.16 (95% CI: 1.04, 1.29)), respectively. Cannabis use was much more common among youth who reported any past 30-day cigarette or alcohol use (44.90% vs. 6.48%, AOR=11.80 (95% CI: 10.57, 13.18)). Declines in cannabis use were observed independent of state-level cannabis law from 2013 to 2021 and cannabis use prevalence did not differ significantly by state-of-residence cannabis legal status among the 24 participating states in 2021. ConclusionsPublic health officials should carefully consider the potential differential impact of expanding commercialization of cannabis and US state government endorsement of cannabis as a “wellness” product on youth, especially with regard to co-use with tobacco and alcohol. National and state-level public health education on cannabis use and youth-oriented prevention of cannabis uptake are long overdue.

Take Health Lessons to the Gym — Part I

Typical health lessons are taught in a classroom setting, where students sit in their chairs and passively receive information. This instructional method may not be the optimal approach, as Ratey discovered in his famous experiment that the human brain is more aroused when the body is physically and actively engaged in the learning environment. The purpose of this two-part article is to illustrate how health content can be delivered with hands-on activities, visual illustrations, and physical tasks that are associated with a specific lesson focus or that require students to repeatedly practice memory recall. Two physical activities in the following five health education topics are presented in this article: (1) mental and emotional health, (2) family and social health, (3) growth and development, (4) nutrition, and (5) personal health and physical activity. Aligned national health education standards and twenty-first-century skills, as well as evaluation for each activity, are also included. Although most of the activities presented in this article are content-specific, a few of the designs can be implemented with a different lesson focus or health topic.

Need for national eye health education policies in Brazil

Need for national eye health education policies in Brazil

Developing the Tokelau National Health and Physical Education Curriculum: A case study

Background: National school curriculum statements detail what it is important to learn and are highly context- and discipline-specific. The health and physical education (H&PE) learning areas have multiple learning purposes, and facilitating this in curriculum design is a significant and challenging task. Objective: There is little reporting on ‘behind-the-scenes’ practices of H&PE curriculum writing, despite this being a key mechanism by which the shaping of curricula occurs. This article offers a descriptive case study of curriculum development for the Tokelau National Curriculum H&PE learning area for Years 0–13. Prior to 2021, this learning area did not formally exist in the Tokelau National Curriculum Framework. Design, Setting and Methods: The case reports on the processes and decisions of a multi-national transdisciplinary writing team from Tokelau, New Zealand and New Caledonia. We explore the questions: ‘Why the need for an H&PE curriculum, and who is it for?’ Document collection and team-based interviews formed the basis for deductive descriptive analysis of the writing processes. Results: Three key themes were developed. Related to ‘why’, findings illustrate the importance of formalising H&PE learning, representing knowledge, skills and capabilities useful for present and future generations of young people in Tokelau. Considering ‘for whom’, findings emphasise the involvement of the community in curriculum decisions, and the inclusion of distinctive features aligned with community values, needs and aspirations. Conclusion: The case study illustrates the requisite coming together of different groups and expertise in the creation of a curriculum, a synthesis of pre-existing and new knowledge and experiences. The focus on health promotion and health and physical literacies exemplifies the everyday use of school curriculum goals to support community health.

This needs to be a journey that we’re actually on together’—the introduction of integrated care systems for children and young people in England: a qualitative study of the views of local system stakeholders during winter 2021/22

BackgroundIntegrated care has become a central feature of health system reform worldwide. In England, Integrated Care Systems (ICS) are intended to improve integration across public health, the National Health Service (NHS), education and social care. By April 2021, England had been divided into 42 geographical areas, each tasked with developing local ICS provision. However, it was not clear how ICSs would address the specific needs of children and young people (CYP). This study elicited the views of senior professional stakeholders in the first year of the ICS national roll out, to learn how integrated care for CYP was being implemented within the ICSs and future plans for service provision.MethodsA qualitative analysis of in-depth interviews with stakeholders, including healthcare professionals, NHS managers and local authority leaders (n = 25) selected from a diverse sample of ICSs (n = 7) across England, conducted during winter 2021/22. Reflexive thematic analysis involving a collaborative coding approach was used to analyse interview transcripts.ResultsFour themes were identified, indicating challenges and opportunities for ICSs in relation to the health of CYP: 1) Best start in life (a more holistic approach to health afforded by integrated care); 2) Local and national contexts (tensions between local and national settings and priorities); 3) Funding and planning (instituting innovative, long-term plans using limited existing CYP funding streams); 4) Organisational complexities (integrating the work of diverse organisations).ConclusionsThe views of stakeholders, provided at the beginning of the journey towards developing local ICS CYP provision, revealed a common aspiration to change focus from provision of acute, largely adult-orientated services towards one with a broader, population health remit, including prevention and early intervention. This would be delivered by integration of a range of local services, including health, education, housing and social care, to set CYP on a life-long path towards improved health and wellbeing. Yet there was an awareness that change would take place over time within existing national policy and funding frameworks, and would require overcoming organisational barriers through further developing local collaborations and partnerships. As ICSs mature, the experiences of stakeholders should continue to be canvassed to identify practical lessons for successful CYP integrated care.

A Biblioguidance Approach to Fostering Students’ Self-Efficacy to Advocate for Health

Teaching the components of health advocacy is straightforward, but fostering young people’s self-efficacy to be health advocates for themselves, others, and their community is more complex. This complexity sometimes renders advocating for health, the basis of National Health Education Standard (NHES) #8, challenging to teach. We utilized a pedagogical approach called biblioguidance to teach this skill to 10th-grade students. The premise of biblioguidance, also called bibliotherapy, is that information, guidance, and even solace can be found through reading and vicariously living story events. To implement this approach, we consulted the literature and created a six-step framework to guide the design, development, and evaluation of a health advocacy curriculum, including young adult novels, guided reading prompts, electronic journals, and small group discussions. Our pre/post-assessment, rooted in NHES #8, evaluated the impact on students’ ( N = 168) self-efficacy to health advocate for themselves, others, and the community. Results revealed a significant change ( p < .001), particularly in advocating for community health. Further, the teachers found that the curriculum facilitated the discussion of health-related topics in subsequent units. We will continue using the curriculum but expand it to include opportunities for authentic application and qualitative data evaluation techniques.

Process evaluation of the Greek nationwide school health education program

Abstract Background Schools can play a significant role in promoting health of the school community. Process evaluation is always needed to gain valuable insights on how next health promotion interventions could be improved. In Greece, the first effort to organize health education interventions in the schools at national level, was in 2019 by the Ministry of Health. The aim of the current study was to evaluate the process of a national school health education program in Greece. Methods The health education interventions took place during school year 2019-2020. They included the following themes: oral health, healthy eating, mental health, sexual health, bullying, and online safety. Multidisciplinary teams co-developed all health education material. A representative sample of teachers and health professionals filled in the structured questionnaires developed for the current study, after their informed consent. Statistical analysis was conducted using SPSS statistical software (version 22.0). Results Most teachers evaluated as excellent (83.6%) the cooperation with the school principal and the health education coordinator (77.6%), while the general satisfaction from the intervention was evaluated as excellent by 69.8% of them. In addition, most of the health professionals (90.7%) perceived as excellent the cooperation with the health education coordinator and the other health professionals (86.3%) as well as the cooperation with the school principal (87%). Conclusions Even though this was the first effort in Greece to organize school health education interventions at a national level, the results of the process evaluation have been positive. Therefore, the Greek Ministry of Health has adopted this program which is implemented until today. Key messages • Process evaluation of school health education interventions is important to improve future initiatives. • Centrally organized school health education interventions may be the key for their success.

Clinicians and AI use: where is the professional guidance?

With the introduction of artificial intelligence (AI) to healthcare, there is also a need for professional guidance to support its use. New (2022) reports from National Health Service AI Lab...

Effects of HIV knowledge on accepting attitudes toward people living with HIV: The case of Southern Vietnam

Context: Increasing thorough knowledge and adopting a positive outlook are crucial intervention strategies in the campaign against HIV transmission. However, the stigma associated with the disease frequently causes discrimination and other human rights violations that affect the well-being of people living with HIV (PLWH). Aims: To evaluate the effects of HIV knowledge on accepting attitudes among the Vietnamese population toward PLWH. Methods: A cross-sectional, self-administered, paper-based survey was conducted. Participants who provided correct answers to 13 out of the 18 questions were considered to have good knowledge, and those who chose “yes” as the response to the first three attitude questions and “no” to the last one were regarded as exhibiting appropriate attitudes. A logistic regression model was used to identify the association between knowledge and attitudes. Results: Among the participants (average age: 23.7 ± 6.4), 90.9% believed they were not at risk of HIV infection, and only 488 (39.8%) had good HIV knowledge. A low proportion (less than 20%) of them exhibited appropriate attitudes. A favorable attitude toward PLWH was significantly correlated with being male and having extensive HIV knowledge. Conclusions: While almost half of Vietnamese adults had good knowledge about HIV transmission, a significant proportion still lacked HIV knowledge and stigmatized people living with HIV. These findings suggest a need for targeted public health interventions, such as a national health education program that emphasizes family life and HIV/AIDS education, to improve knowledge and reduce stigmatization toward PLWH in Vietnam.

Crisis care for children and young people with mental health problems: national mapping, models of delivery, sustainability and experience (CAMH-Crisis2). A study protocol.

One in six five 16-year-olds have a probable mental health difficulty. Of these, almost half of older teenagers and a quarter of 11-16-year-olds report having self-harmed or attempted suicide. Currently, there is little research into mental health crisis services for young people, with little understanding of what services exist, who uses them, or what works best. 'How are mental health crisis responses for children and young people up to the age of 25 sustained, experienced and integrated within their local systems of services'? 1. To describe National Health Service (NHS), local authority, education and third sector approaches to the implementation and organisation of crisis care for children and young people across England and Wales.2.To identify eight contrasting case studies in which to evaluate how crisis services have developed and are currently organised, sustained, experienced and integrated within the context of their local systems of services.3.To compare and contrast these services in the context of the available international evidence, drawing out and disseminating clear implications for the design and delivery of future crisis responses for children and young people and their families. A sequential mixed methods approach, underpinned by normalisation process theory will be employed. A survey will create a detailed record of how crisis responses across England and Wales are organised, implemented and used. Subsequently, eight contrasting services in relation to geographic and socioeconomic setting, populations served, and service configuration will be identified as case studies. Interviews will be conducted with children, young people and parents/carers who have used the service, as well as commissioners, managers and practitioners. Operational policies and service usage data will also be examined. Analysis of how each service is provided, experienced, implemented and sustained will be conducted both inductively and deductively, reflecting normalisation process theory constructs.

Crisis care for children and young people with mental health problems: national mapping, models of delivery, sustainability and experience (CAMH-Crisis2). A study protocol.

Background One in six five -16-year-olds have a probable mental health difficulty. Of these, almost half of older teenagers and a quarter of 11–16-year-olds report having self-harmed or attempted suicide. Currently, there is little research into mental health crisis services for young people, with little understanding of what services exist, who uses them, or what works best. Question ‘How are mental health crisis responses for children and young people up to the age of 25 sustained, experienced and integrated within their local systems of services’? Objectives 1. To describe National Health Service (NHS), local authority, education and third sector approaches to the implementation and organisation of crisis care for children and young people across England and Wales. 2. To identify eight contrasting case studies in which to evaluate how crisis services have developed and are currently organised, sustained, experienced and integrated within the context of their local systems of services. 3. To compare and contrast these services in the context of the available international evidence, drawing out and disseminating clear implications for the design and delivery of future crisis responses for children and young people and their families. Methods A sequential mixed methods approach, underpinned by normalisation process theory will be employed. A survey will create a detailed record of how crisis responses across England and Wales are organised, implemented and used. Subsequently, eight contrasting services in relation to geographic and socioeconomic setting, populations served, and service configuration will be identified as case studies. Interviews will be conducted with children, young people and parents/carers who have used the service, as well as commissioners, managers and practitioners. Operational policies and service usage data will also be examined. Analysis of how each service is provided, experienced, implemented and sustained will be conducted both inductively and deductively, reflecting normalisation process theory constructs.

Knowledge, Attitude, and Practices of Pregnant Women Towards Antenatal Care in Tertiary Care Hospital Somalia: A Prospective Study

Introduction: All women, regardless of their pregnancies, deserve high-quality maternal services during pregnancy, delivery, and afterward. This study aims to evaluate the knowledge and attitude of pregnant women toward antenatal care. Materials and Methods: A prospective study was carried out among pregnant women attending at obstetrics outpatient department of Mogadishu Somali Turkish Training and Research Hospital. The sample was obtained using random sampling methods. In addition, information was gathered using a structured interview schedule between August and October 2022. Results: The majority (63.3%) of respondents were aged between 20 and 24, while 21% were between the ages of 25 and 29, and 8% were between the ages of 30 and 34. One hundred sixty-five pregnant women had primary school education, 31% had secondary education, 15% had a university education, and 11% were illiterate. Only 252 (63.3%) correctly identified the first prenatal check-up within three months. Conclusion: According to the findings, most of the study's participants had a high level of knowledge and good practices, and most had a favorable opinion about ANC. The Federal Ministry of Health's public health department should strengthen national health education programs to promote antenatal care.

Effect of the National Health Education Program among Saudi Patients in Saudi Arabia Primary Health Care Centers, 2019

Health education (HE) is important in improving public health. Globally, the evaluation HE quality is an important obstacle to better interventions, and wider acknowledgment of As a result, the purpose of this research is to improve the quality of health education services by providing a current perspective on current evidence on the effect of the HE national program in primary health care centres (PHCCs) through the following objectives: To calculate the frequency of receiving HE To measure patient satisfaction with the provided HE service. To assess patient self-control and its determinants in chronic diseases. An analytical cross section study targeted randomly selected 1590 Saudi PHCCs visitors from the main five regions in the Kingdom of Saudi Arabia (KSA). Through exit interview using a pretested, well-structured questionnaire composed of four parts. The majority of participants were females (73.5%) and married (69.1). Of those, 64.9% had chronic diseases. The frequency of receiving HE was 51.1%. The health-educated patients significantly had better self-chronic disease control and an improvement in health status. The HECs shows a significant self-patient control of chronic diseases and patient satisfaction than HE services. HE interventions must be multidimensional to be effective in improving patients’ clinical outcomes through the increase and maintenance of healthy behaviours. Keywords: health education, Saudi patients, primary health care centres, Saudi Arabia

The effect of community-based health education programs on health literacy in severely impoverished counties in Southwestern China: Results from a quasi-experimental design.

A national health education program in impoverished counties to promote health literacy among rural populations was released by the Chinese government in 2018. Under this nationwide campaign, an integrated health education program was implemented in Yunnan province, which included additional culturally sensitive educational components for the severely impoverished prefectures. This study examined the differential effects of the health education program models on health literacy outcomes among residents in poverty-stricken areas. A quasi-experimental design was applied with two arms that included surveys at baseline (in October 2019) and endline (in June 2021) to collect a range of individual-level health information, including the Chinese Resident Health Literacy Scale. The intervention group received the national health education program with the additional Yunnan specific program; the control group received only the national program. Respondents were recruited via a multi-stage stratified sampling, including 641 participants at baseline (261 from the intervention sites and 380 from the control sites) and 693 participants at endline (288 from the intervention sites and 405 from the control sites). Chi-square and logistic regression analyses were performed to examine the association between program intervention and health literacy outcomes. The overall health literacy levels were low (1.87%) at baseline, and there was no statistically significant difference between two groups (1.92 vs. 1.84%, P = 1.000). A significant increase (from 1.87 to 11.11%, P < 0.001) in the health literacy level was observed at endline in both groups. The magnitude of increase was significantly greater in the intervention group relative to the control group (17.71 vs. 6.42%, P < 0.001). Adjusting for the confounding factors of individual and household characteristics, results from multivariate logistic regression revealed that the odds of having adequate health literacy among participants who received both the National Program and the Yunnan Program were 3.92 times higher than those who only received the National Program (95% CI: 2.10-7.33). The findings highlighted the importance of incorporating non-verbal visual aids and culturally-sensitive media tools in health literacy education to address healthy lifestyle and the living contexts of the populations in poverty-stricken areas.

Functional Health Literacy, Invented Spellings, and MyPlate Representations of 2nd and 3rd Grade Children Learning about Breakfast Eating and Food Groups in Health Education

PURPOSE: We had three purposes for this study: 1) to introduce 2nd and 3rd grade children to the concepts of breakfast and food groups in the MyPlate nutrition model while using an interactive constructivist approach; 2) to evaluate what foods children ate for breakfast over two days and to assess the visual-textual-lexical representations that they constructed to show their thinking about the MyPlate food model; and 3) to explore functional health literacy and inventive spellings from children who learned about food groups over two class sessions. METHODS: Pre to post student assessments focused on self-reported breakfast eating and ability to represent the MyPlate food model during the learning process. Student thinking about those topics were also elicited by multimodal approaches: oral language (conversations), written language (visual-textual-lexical illustrations), and body language (making nutritious snacks). For the latter, students constructed a snack to eat on both days at school and were encouraged to make the food at home to model nutritious eating behavior. RESULTS: Most children who participated in the lesson ate breakfast either at home or at school. Some students chose to communicate in words and pictures when asked to write about the foods they ate for breakfast. Many students illustrated and labeled food groups by drawing and using inventive spellings about their early understandings of the MyPlate food model. From the first to the second day of instruction, breakfasts with three food groups increased from 3% to 7% but breakfasts with two food groups declined from 55% to 41% due to more children (n = 60) eating breakfasts with only one food group on the second day. CONCLUSIONS: Some of the food items that students ate were not sufficient to produce an adequate nutritional benefit. The constructivist pedagogical approach assisted children with multimodal ways to communicate their understanding, including making two different snacks when planning a breakfast with multiple food groups. Functional health knowledge about a nutritious breakfast made with three food groups should be further aligned with functional health literacy skills of speaking and writing in multimodal ways in order to improve health behaviors. Inventive spellings demonstrated a developmental step in learning a vocabulary in a new domain. Use of written words and pictures reflected a positive way to learn health and nutrition, because children represented their understanding in more than one way. RECOMMENDATIONS: By adding fruit to the breakfasts of children who participated in the lessons, almost one-half of the children would be able to increase their consumption from two food groups to three food groups when consuming an ideal breakfast. Future work should elaborate on the role of interactive health literacy in school and home contexts when children are learning about breakfast eating and food groups. Future integration of the MyPlate food model with the National Health Education Standards can foster new classroom assessments that will support students to practice observable nutrition behaviors that can lead to consistent health habits for personal, family, and school health.