Why study Health Education?
Health Education is relevant to students’ lives and supports students’ health, resilience, total well-being, and academic success so they may reach their aspirations, from early learning through college, career, and citizenship.
Healthy students are better learners (Michael, 2015). Standards-based Health Education contributes to supporting the whole child as part of a well-rounded educational experience.
Hawaii’s youth face many challenges as they grow up. The 2019 Youth Risk Behavior Survey shows that among Hawaiʻi’s high school students:
10.5 percent attempted suicide in the past 12 months.
34.7 percent felt sad or hopeless almost every day for two or more weeks in a row that they stopped doing some usual activities in the past 12 months.
45.5 percent used a condom during last sexual intercourse (among students who were currently sexually active).
48.3 percent used an electronic vapor product.
14.6 percent were electronically bullied in the past 12 months.
60.8 percent had at least one teacher or other adult in their school they could talk to if they had a problem.
66.9 percent had an adult outside of school they could talk to about things that were important to them.
Providing students with a high-quality, comprehensive Health Education equips and empowers them with the skills, knowledge, and attitudes to address their current and future health needs and challenges. Health literacy is essential to students’ social, emotional, mental, physical, and cognitive development.
Health-literate individuals are able to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. This contributes to one's health, resilience, well-being, healthy relationships, and a positive quality of life as well as prevents and reduces the risk of disease, injury, and death. In addition to maintaining and enhancing their own health, health-literate individuals are also able to advocate for the health of others.
Core Principles of Health Education
Develops Health Literacy Skills
The National Health Education Standards (NHES) “provide the framework for increasing positive health behaviors by teaching skills that are relevant and applicable to daily life. These, paired with accurate and developmentally appropriate information, based on student need and derived from local data, provide the context for skill development and the foundation for a comprehensive health education program" (SHAPE America, 2018).
The primary focus of high-quality standards-based health education curriculum, instruction, and assessment are to develop health literacy skills to proficiency within and across grade levels:
Standard 1: Comprehending Concepts
Standard 2: Analyzing Influences
Standard 3: Accessing Resources
Standard 4: Interpersonal Communication
Standard 5: Decision-Making
Standard 6: Goal-Setting
Standard 7: Self-Management
Standard 8: Advocacy
Students are provided with regular opportunities and time to practice these skills and engage in peer feedback and self-assessment. During Health Education instruction, educators should always utilize developmentally appropriate, trauma-sensitive, culturally responsive and sustaining, and inclusive practices to address learner variability and reduce barriers to learning.
The following model for skill development was developed from the National Health Education Standards and the World Health Organization. Teachers should include all five elements of this model when designing meaningful learning opportunities for students to practice and reinforce health skills.
Introduce the skill by discussing the importance of the skill, its relevance, and its relationship to other learned skills.
Present the essential elements of the skill (i.e., skill cues).
Model the skill using relevant, realistic scenarios, and highlight the essential elements of the skill.
Practice and apply the skill using relevant, realistic scenarios, and provide opportunities for self-assessment, reflection, and feedback.
Strengthen the skill with opportunities to transfer and apply the skill beyond the classroom, which may include sharing and exploring new learning with others (e.g., family, friends, peers).
It is critical to ensure that students have a clear understanding of what they are learning and what successful learning looks like throughout their learning experiences. Standards-based assessments for health education provide evidence of students’ current level of performance related to health skill performance and functional knowledge acquisition. Assessments should include scenarios that students might experience in real life (e.g., at home, in school, and in the community). A variety of assessments (e.g., performance task, role play, advocacy campaign, constructed response) may be used to allow all students to demonstrate what they know and are able to do in relation to the National Health Education Standards (NHES) and Performance Indicators.
Builds Functional Knowledge
While the primary focus of Health Education is the development of health skills, these skills must be addressed in conjunction with functional information in the context of Priority Health Topics. Standards-based Health Education must be age and developmentally appropriate, medically accurate, and provide factual information in all Priority Risk Topics:
Mental and Emotional Health
Healthy Eating and Physical Activity
Personal Health and Wellness
Safety (Unintentional Injury Prevention)
Tobacco Use Prevention
Alcohol and Other Drug Use Prevention
Sexual Health and Responsibility
Functional information provides the context in which students learn and apply skills. It is relevant and applicable information that directly contributes to maintaining and enhancing their health and the health of others. This information is utilized to help students develop health skills in class.
When determining functional information that supports skill development, educators may consider asking “What information about this topic do my students need in order to apply the skill being covered effectively?,” and “When my students learn this information, how will they use it to benefit their health or the health of those around them?” (Benes, 2022). As functional information is processed and internalized, it becomes functional knowledge that students can apply in real-life situations.
Nurtures Attitudes that Support Positive Health Behaviors
In addition to developing skills and functional knowledge, students have opportunities to explore and analyze diverse stories, ideas, and influences on health and well-being; examine their own identities, perspectives, beliefs, and values; and engage in learning experiences that strengthen health-promoting attitudes about healthy behaviors and preventing and reducing risky behaviors.
The Youth Risk Behavior Survey (YRBS) is administered in odd-numbered years to Hawai‘i public school students in grades 6–12 to monitor priority behaviors that contribute to the leading causes of morbidity and mortality among youth and young adults (Saka, 2021). Age and developmentally appropriate use of YRBS data within health education classes may be used to build student interest in a health topic, challenge youth perceptions on health behaviors, and support health skill development (e.g., evaluate and analyze health information, advocate for the health of self and others). The YRBS data may also be used to identify key areas of focus for curriculum design and professional development.
Addresses Students’ Strengths, Interests, Needs, and Challenges
Health education occurs within inclusive and supportive learning environments that foster a culture of learning and address the diverse learning needs of all students. A respectful and caring learning environment allows students to feel safe to share and reflect on their perspectives, interact with others, take risks to enhance their learning, and ask sensitive questions.
Student-centered, interactive instructional strategies are utilized to engage students in learning health literacy skills within a social context. Examples of participatory methods include role play, large- and small-group discussions, debates, cooperative learning, problem-solving, and simulations (CDC, 2019).
Providing relevant and meaningful opportunities for students to connect with their family and community is a critical component of Health Education. This can occur in a variety of ways, including conversations and activities for students and their ʻohana, resource mapping, ʻāina-based learning, hands-on learning (e.g., taste-testing, food preparation), health-related advocacy efforts, youth participatory action research, and service learning (e.g., peer education).
Where is Health Education headed?
The National Health Education Standards: Achieving Excellence (NHES) were adopted by the Hawai'i State Board of Education in December 2019. A three-year implementation rollout began in School Year (SY) 2020-2021, with full implementation of the NHES in SY 2023-2024.
The HIDOE is focusing on communicating resources and appropriate training to support schools and the full range of educators through in-person and virtual venues. Additional resources to support appropriate practices are in development.
Note: Health Education in Pre-kindergarten is aligned to the Hawai‘i Early Learning and Development Standards (HELDS).
Health Education Resources
Board of Education policies, HIDOE guidelines
Curriculum, Instruction & Assessment
Benes, S., & Alperin, H. (2022). The essentials of teaching health education: Curriculum, instruction, and assessment (2nd ed.). Human Kinetics.
Centers for Disease Control and Prevention [CDC]. (2019). Characteristics of effective health education curricula. https://www.cdc.gov/healthyschools/sher/characteristics/index.htm
Michael, S. L., Merlo, C. L., Basch, C. E., Wentzel, K. R., & Wechsler, H. (2015). Critical connections: Health and academics. Journal of School Health, 85(11), 740-758.
Society of Health and Physical Educators [SHAPE] America. (2018). Health education is a critical component of a well-rounded education [Position statement]. Author. https://www.shapeamerica.org/advocacy/positionstatements/health/upload/HE_Critical_Component_Position_Statement.pdf
SHAPE America. (n.d.). What is health literacy? https://www.shapeamerica.org/publications/products/health-literacy.aspx
Saka, S. M., Gerard, K., & Afaga, L. (2021). Results of the 2019 Hawaiʻi state and counties youth risk behavior surveys (YRBS) and cross-year and national comparisons. University of Hawaiʻi at Mānoa Curriculum Research & Development Group.