Health for Life is research-based and theory-driven. The book relies on several key theories that inform the text’s content as well as the learning opportunities provided for students. These theories include:
Social cognitive theory. Social cognitive theory is also referred to as social learning theory. This theory emphasizes the importance of self-efficacy and positive expectations in making behavior changes. It also emphasizes the importance of trying ability-appropriate tasks to gradually enhance self-efficacy for a specific task. The theory suggests that a person must value the outcomes of a behavior if a change in behavior is the goal.
Self-determination theory. Central to self-determination theory is personal autonomy. Autonomy refers to the ability of a person to make his or her own decisions. Feelings of competence at mastering skills or tasks are also critical to the theory. Making personal choices are emphasized rather than making choices based on external pressures to comply. Intrinsic (internal) motivation is considered to be more important than extrinsic (external) motivation (e.g., rewards, payments). In self-determination theory intrinsic motivation is a major factor in making choices to adopt a behavior because it makes them fulfilling (rather than coerced).
Theory of reasoned action. This theory suggests that a person’s behavior is most associated with the person’s stated intention to carry out the behavior. According to this theory a person’s intentions are influences by attitudes (beliefs) and the social environment (opinions of others).
Theory of planned behavior. This theory has many of the basic tenets of the theory of reasoned action, but adds the concept of perceived control over the environment. If a person is to change a behavior, he or she must believe that he or she has some control over the factors that influence the behavior. Perceived control is in many ways similar to self-efficacy in social cognitive theory.
Health belief model. A model is similar to a theory in that it provides a blueprint for behavior change. This model suggests that a person’s health behavior is related to five factors: the belief that a health problem will have harmful effects, the belief that a person is susceptible to the problem, the belief that the perceived benefits of changing a lifestyle will prevent the problem, the belief that overcoming barriers to the problem will solve the problem, and confidence that he or she can do what is necessary to prevent or solve a problem.
Social-ecological model. The social ecological model is based on the idea that health behavior change is influenced by the interaction of cultural, social (intrapersonal), and physical environmental factors. For example, when people practice a negative behavior such as smoking, they affect the environment. Others in the environment are then exposed to a health risk. Unlike the other theories and models, the social ecological model emphasizes the importance of a multitude of social and environmental factors rather than personal health behavior change.
Trans-theoretical model. This model is also referred to as the stages of change. The model uses elements of all of the previously described theories and models. As noted in the student text, the model suggests that health behavior change does not occur all at once. Rather, five different stages exist and behavior change occurs when people move from one stage to another. The model also emphasizes the importance of the process of change including factors such as goal setting, self-monitoring, self-assessment, and self-planning.
Each of the Skills for Healthy Living features present in the text are derived from these theories and models. The Skills for Healthy Living are self-management skills that help students change, or enhance, their lifestyle. There are three kinds: those that help with beginning to change, those that help make a change, and those that help maintain a change. These skills are presented in the student text and activities that help develop the skills are supported by the lesson plans. Skills for Healthy Living provide the basis for adopting healthy lifestyles. Students, not only learn about these self-management skills, they get the opportunity to practice them. As with any skill, practice is critical to the effective use of self-management skills.
Aligned with CDC Essential Qualities
CDC Essential Qualities for an Effective Health Education Curriculum
The Center for Disease Control and Prevention has identified four qualities that are essential to an effective health education curriculum. Each of these is reflected in the Health for Life program as stated below:
- Teaching functional health information (essential knowledge). Health for Life focuses the student text on relevant, meaningful and accurate foundational knowledge that addresses all essential health education topics including the prevention of alcohol, drug, and tobacco use; the promotion of priority lifestyles (physical activity, nutrition and stress management); the promotion of mental, emotional, personal and sexual health and wellness; as well as the promotion of safety and prevention of violence.
- Shaping personal values and beliefs that support healthy behaviors. Health for Life challenges students to explore their values and beliefs and provides them with repeated opportunities to examine what influences their values and beliefs and how their behaviors are changed as a result.
- Shaping group norms that value a healthy lifestyle. Throughout Health for Life students are given opportunities for peer-to-peer interactions that help to affirm health-promoting beliefs, counter perceptions about peer behaviors in relation to risky health behaviors, and promote healthy choices in their school, family and community.
- Developing the essential health skills necessary to adopt, practice, and maintain health-enhancing behaviors. In every chapter of Health for Life students engage in self-assessing their own health status and behaviors, setting health behavior goals and creating action plans for behavior change. In addition, each chapter provides opportunities for skill development in relation to self-management skills such as goal setting, time management, improving self-esteem, developing refusal skills, providing social support, and many others.
The CDC states that “less effective curricula often overemphasize teaching scientific facts and increasing student knowledge”. While it is important to learn basic health knowledge and to gain health literacy, effective curriculum must help translate that knowledge into usable skills that promote long term behavior change. As such, experts in the field of health education have identified a set of characteristics that are associated with an effective overall curriculum that helps to promote long term behavior change1-14. These characteristics include:
- Focuses on clear health goals and related behavioral outcomes. Health for Life demonstrates this characteristic in several ways. First, each unit of the text identifies the Healthy People 2020 behavioral objectives that are reinforced in the associated chapters. In addition, the first unit of the book teaches students the foundations of behavior change, and each subsequent chapter provides opportunities for developing behavior change and self-management skills. Through features such as Self-Assessment and Planning for Healthy Living students are also given opportunities to develop relevant behavioral outcomes and to set their own health goals.
- Is research-based and theory-driven. Health for Life relies on several key theories that inform the text’s content as well as the learning opportunities provided for students.
- Addresses individual values, attitudes, and beliefs. Health for Life provides multiple opportunities for students to examine personal attitudes, values, and beliefs through discussions, debates and consensus building activities as part of the Healthy Communication and Connect features in the text. In addition, the lessons associated with each chapter provide opportunities for exploration of how individual and societal values, attitudes and beliefs influence health behaviors.
- Addresses individual and group norms that support health-enhancing behaviors. Throughout Health for Life students are provided with points of reference about positive and negative norms and trends related to specific health behaviors. In addition, many of the lesson plans provide opportunities for students to analyze, role play and identify how norms impact health decisions and health behaviors among individuals, groups and society at large.
- Focuses on reinforcing protective factors and increasing perceptions of personal risk and harmfulness of engaging in specific unhealthy practices and behaviors. According to the CDC, this characteristics means that “an effective curriculum provides opportunities for students to validate positive health-promoting beliefs, intentions, and behaviors. It provides opportunities for students to assess their vulnerability to health problems, actual risk of engaging in harmful health behaviors, and exposure to unhealthy situations.” Every chapter of Health for Life provides an individual Self-Assessment and asks students to evaluate their personal risks related to a variety of health behaviors and choices and provides them with opportunities to define goals to change unhealthy behaviors or maintain healthy ones.
- Addresses social pressures and influences. This characteristic is well supported throughout Health for Life and the associated lesson plans. In addition, the Connect feature questions, which provide opportunities for students to focus on the analysis of social pressures, media influences and peer pressures to engage in unhealthy, and healthy, behaviors, are also a central feature of each chapter.
- Builds personal competence, social competence, and self-efficacy by addressing skills. Building essential skills such as communication, refusal, information literacy, decision-making, planning and goal-setting, self-control, and self-management are critical elements of Health for Life. Each chapter in the text contains a Making Healthy Decisions feature and a Skills for Healthy Living feature which are also the focus of a dedicated lesson plan each week. For each lesson plan that focuses on skill development related to the Skills for Healthy Living, students are guided through a series of developmental steps:
- Identifying the importance and relevance of the skill through a designated case study and discussion questions (presented in the text).
- Specific steps for skill development (presented in the text).
- Opportunities to model and practice or rehearse the skill (presented in the lesson plans).
- Opportunities for feedback and further practice and reinforcement (presented in the lesson plans).
- Provides functional health knowledge that is basic, accurate, and directly contributes to health-promoting decisions and behaviors. The content in Health for Life is carefully selected to support healthy decision making and healthy behavior change. Each lesson plan provides a Lesson Application where student knowledge is used to support health-promoting decisions and behaviors. In addition, while Health for Life provides a full range of health education topics, special emphasis is given to the priority healthy lifestyles of physical activity, nutrition and stress management.
- Uses strategies designed to personalize information and engage students. The lesson plans associated with Health for Life each have five elements: Bell Ringer, Lesson Focus, Lesson Application, Summary and Review, and Evaluate. From the reflective journal questions found in the Bell Ringer, to the student-centered, interactive and experiential opportunities found in the Lesson Application, students are given multiple opportunities to engage with the content in ways that are both personal and relevant. Each chapter review in the text provides a critical thinking question as well as a project opportunity. Key health concepts, creative expression, personal reflection, diverse perspectives and critical thinking skills are developed through the wide range of instructional strategies used in the lesson plans.
- Provides age-appropriate and developmentally-appropriate information, learning strategies, teaching methods, and materials. Health for Life is organized in a logical way such that students have the opportunities to understand and develop behavior change, self-management skills, self-assessment and goal setting in relation to health enhancing behaviors. Students are given opportunities for self-reflection, mastery of content knowledge, application of critical health information, self-assessment and evaluation, peer interaction, goal setting and program planning, and self-management skill development. In addition, the Health Technology and Health Science features bring age appropriate topics of interest to high school students (i.e. internet safety, the use of computer applications to assist behavior change and evaluating web information). Together, these opportunities empower students to make healthy choices now and throughout their lives.
- Incorporates learning strategies, teaching methods, and materials that are culturally inclusive. Health for Life is committed to cultural diversity through its presentation (i.e. art, illustrations and photographs), examples used (i.e. Making Health Decisions and Diverse Perspective features), information provided (i.e. cultural influences on specific health behaviors, cultural differences in health and health behaviors) and learning opportunities and assignments given (i.e. analyzing one’s own cultural influences on health decisions and behaviors).
- Provides adequate time for instruction and learning. Health for Life is a comprehensive, semester long program that encompasses five daily lesson plans for each of 21 text book chapters. Lesson plans focus on understanding and applying content knowledge to health problems and decisions; self-assessment of health behaviors; self-management skill development; and the development of critical thinking skills.
- Provides opportunities to reinforce skills and positive health behaviors. Health for Life allows high school aged students to consider their current health status as well as their life-long health needs and goals. Students are given opportunities to learn, apply and revisit health goals and plans throughout the term. Connections to other academic areas are also made in both the text (i.e. communication skills, technology and science) and in the lesson plans (i.e. reading comprehension and mathematics).
- Provides opportunities to make positive connections with influential others. Every Health for Life lesson provides an opportunity to connect with family and community in the Take It Home feature. Students are encouraged to share their health knowledge with others, explore shared and divergent values with friends and family members, utilize experts and others in decision making processes, explore norms that influence their choices and actions, and directly influence other’s health behaviors. Advocacy in Action features found in each unit also provide opportunities to work with others to influence health behaviors.
- Includes teacher information and plans for professional development and training that enhance effectiveness of instruction and student learning. Health for Life lesson plans provide aligned instruction (learning outcomes, lesson focus and application activities and assessment and evaluation activities are intentionally designed to support one another) and provide specific tips to enhance instruction. All materials are also designed in such a way that they can be modified or enhanced as instructors gain new and additional knowledge through professional development opportunities.