Version 3.

Updated August 2021

HEALTH EDUCATION :
Evidence-Informed Practice Brief
WHAT DO WE MEAN?
Health Education refers to planned learning opportunities during
which students acquire knowledge and skills to engage in health-
informed decision making and adopt lasting healthy behaviors.1
Health education curricula should be based on assessment of
student and community health needs, planned in collaboration
with the community, and include an assortment of topics that
address relevant health needs. Instruction should be offered for
students in grades pre-kindergarten through 12 and provided by
qualified and trained teachers.1 In addition to classroom lessons
or activities, students may obtain health information during visits
to the school nurse or related providers, through posters or
public service announcements, and through general
conversations with teachers, peers, and family.

As health education is wide-ranging and extensive, it is essential

that qualified professionals establish and deliver curricula that
effectively and efficiently guide student learning. In addition,
health education instructors are encouraged to participate in relevant and continued
professional development.1 Effective curricula focus on well-defined health goals and outcomes
using a research-based and theory-driven approach.1 To work towards reducing educationally-
relevant health disparities,2 health education instruction must be age-appropriate and developed
using culturally relevant materials, learning strategies, and teaching methods. More specifically,
an appropriate school-based health education program will address the National Health
Education Standards (NHES).4 These standards can support teachers, administrators, and
policymakers in promoting healthy behaviors and health-based decision-making through
curriculum development, teaching strategies, and student assessment. Further, NHES promotes
a shared understanding of what comprises health education across students, families, and
communities. The standards support school personnel, families, and community members in
fostering student understanding of health promotion and disease prevention, analyzing the
effect of social influences on health behaviors, and accessing reliable health-promoting
information and services.4 Students should also be taught to apply health-promoting knowledge
to interpersonal communication, decision-making, and goal-setting to enhance and advocate for
their health.4 Together, this work can contribute to reducing intergenerational health disparities
and risks.

V3.WSCC Practice Brief: Health Education was created by the UConn Collaboratory on School and Child Health.
Copyright © 2018, 2020, 2021 by the University of Connecticut. 1
All rights reserved. Permission granted to photocopy for personal and educational use as long as the names of the
creators and the full copyright notice are included in all copies.

csch.uconn.edu | @UConnCSCH
WHY IS IT RELEVANT TO CHILD OUTCOMES?
Physical Health Outcomes
School-based health education positively impacts students’ physical health, extending beyond
physical activity in gym classes. For instance, education around nutrition and healthy eating
habits is associated with increased student fruit and vegetable consumption,10,21 reduced fat
consumption,21 and increased physical activity.14 Further, health education seeks to promote
prevention of chronic diseases such as cardiovascular disease and cancer through education
on topics such as healthy eating.14 In addition, sexual health education has been found to
reduce the likelihood of teen pregnancy and successfully prevent sexually transmitted
infections.12,17 Several review studies suggest that substance use education can reduce and
delay use of substances such as alcohol, marijuana, and other drugs.18,20,32 However, schools
should consider appropriate developmental timing and packaging of this content as the
effectiveness of programs can vary depending on student age.25 Specific education about
medication (e.g., medication adherence, side effects) can improve student knowledge,
confidence, and appropriate use of medication. 13 Overall, effective health education can
promote healthy behaviors and prevent and reduce the negative, long-lasting, and sometimes
life-threatening physical effects associated with unhealthy behaviors.

Social, Emotional, and Behavioral Outcomes

Health education is associated with positive social, emotional, and behavioral outcomes. For
example, prevention and health promotion programs surrounding alcohol and substance use
can reduce symptoms of depression, anxiety, and antisocial behavior.30 Additionally, students
have reported feeling less inclined to engage in substance use and unsafe sexual activity as a
result of health education programs.3,19,27 Students who are exposed to gender-inclusive
language (e.g., in classroom discussions, in written materials) report feeling more comfortable
talking to adults about a variety of concerns. 8,9 Programs targeting healthy eating behavior have
also been effective in improving students’ attitudes toward healthy foods and preferences, which
can lead to healthy food choices.10 However, it is important to tailor education and intervention
on health behaviors to meet the social, emotional, and behavioral needs of all students. For
example, interventions targeting sexual health may be more successful with students of Latinx
backgrounds when focused on delaying sexual intercourse, whereas interventions focused on
contraceptive use may be more successful with White adolescents.27 Not only does health
education have the capacity to influence student behavior and physical health, it plays a role in
students’ emotions and attitudes.

Academic Outcomes
Research demonstrates a strong connection between healthy behaviors and academic
achievement, including improved grades, standardized test scores, graduation rates, and
attendance.2,23,29 For example, healthy nutrition, physical activity, and adequate sleep are
associated with academic success.16,25 Additionally, academically successful students are less
likely to smoke cigarettes, use vaping products, or drink alcohol before the age of 13.5,29 Since
unhealthy behaviors such as poor eating habits, physical inactivity, and substance use are
commonly associated with lower academic achievement,29 teaching and practicing healthy
lifestyle behaviors is a component of effective health education curricula that promotes positive
academic outcomes. Overall, health education is a critical means for intervening on any
negative effects such behavior may have on student success.

V3.WSCC Practice Brief: Health Education was created by the UConn Collaboratory on School and Child Health.
Copyright © 2018, 2020, 2021 by the University of Connecticut. 2
All rights reserved. Permission granted to photocopy for personal and educational use as long as the names of the
creators and the full copyright notice are included in all copies.

csch.uconn.edu | @UConnCSCH
 HEALTH EDUCATION: EVIDENCE IN ACTION
The strategies provided here summarize a review of available evidence and best practice recommendations in this
domain.* Strategies are grouped by anticipated resource demand (e.g., funding, time, space, training, materials).
Level 1 Strategies: Low resource demand
Use the Health Education Curriculum Analysis Tool (HECAT)
o HECAT can help schools select and/or develop appropriate and effective health education curricula, as well
as improve the delivery of health education for student and community needs.6
o Schools can use this tool to review curriculum, score the accuracy, acceptability, and feasibility of
curriculum content, and track scores over time.6
Align health education curricula with community needs and student interests
o Health education focused on cultural fit and the integration of multiple community systems is associated
with improved outcomes7,27 – that is, two different school districts may need education surrounding the
same health topic, but the information may be delivered in different ways.27
o Gender-inclusive language increases student comfort with discussing a variety of concerns with adults.8,9
o Schools should deliver up-to-date and inclusive health education curriculum in a developmentally tailored,
o
culturally relevant, and community-focused manner that prioritizes student interests.18,27
Level 2 Strategies: Moderate resource demand
Promote family involvement in health education
o Family involvement can play a pivotal role in delaying the onset and use of alcohol and other drugs among
children and can improve healthy student behaviors (e.g., consumption of fruits and vegetables).7,21,31
o Health education can promote family involvement by providing families with newsletters and information
sheets, including family-student homework assignments, and offering family-student and family information
sessions as part of the health education curriculum.21
Use multiple active-learning components in teaching health education
o Instructional programs that provide opportunities for active engagement are associated with reduced risk-
taking behaviors, including decreased drunk driving and delayed initiation of sexual activity.11,27
o Health education lessons should include active-learning components21 that can be delivered in person or
virtually, such as role-playing, opportunities to practice healthy lifestyle skills, practice interpreting nutrition
and medication labels, and meal planning and preparation.10,13,15,18
Level 3 Strategies: High resource demand
Incorporate social learning approaches into health education activities
o Approaches that use social learning theory – the idea that people learn by observing others’
behavior/attitudes and the outcomes of those behaviors – are associated with positive impacts on student
attitudes and reductions in risk-taking behavior.10,18,21,27
o Prevention curricula should incorporate aspects of social learning theory into lessons, such as through
opportunities to practice unpacking positive and negative media messages (e.g., whether a commercial is
promoting health or unhealthy eating) and identifying ways in which social media and other influences can
encourage healthy and unhealthy behaviors.18,25,27
Integrate health education across grade levels and subject areas
o Comprehensive and inclusive health education is recommended across pre-K through 12th grade. To best
promote equitable outcomes, health education should cover multiple years24 (thus increasing student
access), be developmentally appropriate, and be tailored to meet the diverse needs of the
community.18,26,27 For example, the effectiveness of substance use prevention programs has shown to vary
depending on developmental timing; this should be considered when selecting appropriate health
education curricula.25,26
o Health education should also be integrated into other academic subjects.10,21,22,28 For example, teachers
can assign and discuss age-appropriate books that discuss health-related topics during language arts or
have students interpret nutrition labels as part of a math exercise.
*For more information about the systematic review process we used to identify evidence-based practices, please refer to
our overview brief which can be found here.

V3.WSCC Practice Brief: Health Education was created by the UConn Collaboratory on School and Child Health. 3
Copyright © 2018, 2020, 2021 by the University of Connecticut.

All rights reserved. Permission granted to photocopy for personal and educational use as long as the names of the
creators and the full copyright notice are included in all copies.

csch.uconn.edu | @UConnCSCH
ADDITIONAL RESOURCES
Note: The WellSAT WSCC allows users to evaluate district policy alignment with ‘best practices’ in policy
associated with Health Education and other WSCC model domains.

Alliance for a Healthier Generation American Public Health Association

Health Education Center for School, Health and Education
This webpage includes health education Become a member here to join discussions,
assessment tools for evaluating health education in debates, and receive up-to-date news and
your school, suggestions for improvement, and research findings related to school health
resources covering essential topics such as healthy education.
eating, physical activity, and more.
Resources CDC
This webpage offers a list of links to tools and Characteristics of an Effective Health
resources to help schools take action in health Education Curriculum
education. This website, reviewed in 2019, provides a detailed
list and description of important health education
American Cancer Society, American curriculum characteristics developed by experts in
the field.
Diabetes Association, American Heart
Association
Connecticut State Department of
Health Education in Schools: The Importance
Education
of Establishing Healthy Behaviors in our
Comprehensive School Health Education
Nation’s Youth This website includes an overview of health
This statement from the American Cancer Society,
education, health education teacher evaluation
American Diabetes Association, and American
resources, guidelines to curriculum development,
Heart Association outlines why health education is
and other related resources.
important in the schools, what quality school health
education should look like, and suggested
strategies to support implementation. Society of Health and Physical Educators
(SHAPE)
Appropriate Practices in School-Based Health
Education
This 2015 guide of best practices was created to
assist teachers and administrators in developing
and delivering health education that meets local,
state, and national standards.

V3.WSCC Practice Brief: Health Education was created by the UConn Collaboratory on School and Child Health.
Copyright © 2018, 2020, 2021 by the University of Connecticut. 4

All rights reserved. Permission granted to photocopy for personal and educational use as long as the names of the
creators and the full copyright notice are included in all copies.

csch.uconn.edu | @UConnCSCH
SOURCES
1 12
Association for Supervision and Curriculum Goesling, B., Colman, S., Trenholm, C., Terzian, M.,
Development (ASCD) & Centers for Disease Control & Moore, K. (2014). Programs to reduce teen
and Prevention (CDC) (2014). Whole school, whole pregnancy, sexually transmitted infections, and
community, whole child: A collaborative approach to associated sexual risk behaviors: A systematic
learning and health. review. Journal of Adolescent Health, 54, 499-507.
13
http://www.ascd.org/ASCD/pdf/siteASCD/publications/ Guirguis, L. M., Singh, R. L., Fox, L. L., Neufeld, S.
wholechild/wscc-a-collaborative-approach.pdf M., & Bond, I. (2020). Medication education provided
2
Basch, C. E. (2011). Healthier students are better to school-aged children: A systematic scoping review.
learners: A missing link in school reforms to close the Journal of School Health, 90(11), 887–897.
14
achievement gap. Journal of School Health, 81, 593- Howerton, M. W., Bell, B. S., Dodd, K. W., Berrigan,
598. D., Stolzenberg-Solomon, R., & Nebeling, L. (2007).
3
Caan, W., Cassidy, J., Coverdale, G., Ha, M. A., School-based nutrition programs produced a
Nicholson, W., & Rao, M. (2015). The value of using moderate increase in fruit and vegetable
schools as community assets for health. Public consumption: Meta and pooling analyses from 7
Health, 129, 3-16. studies. Journal of Nutrition Education and
4
Centers for Disease Control and Prevention (CDC). Behavior, 39, 186-196.
15
(2019). National Health Education Standards. Jacob, C. M., Hardy-Johnson, P. L., Inskip, H. M.,
https://www.cdc.gov/healthyschools/sher/standards/in Morris, T., Parsons, C. M., Barrett, M., Hanson, M.,
dex.htm Woods-Townsend, K., & Baird, J. (2021). A
5 systematic review and meta-analysis of school-based
Centers for Disease Control and Prevention (CDC). interventions with health education to reduce body
(2021). Healthy schools. mass index in adolescents aged 10 to 19 years. The
https://www.cdc.gov/healthyschools/health_and_acad International Journal of Behavioral Nutrition and
emics/index.htm Physical Activity, 18(1).
6
Centers for Disease Control and Prevention (CDC). 16
Kann, L., McManus, T., Harris, W.A., Shanklin, S.L.,
(2021). Health education curriculum analysis tool Flint, …& Zaza, S. (2016). Youth risk behavior
(HECAT). https://www.cdc.gov/healthyyouth/hecat/ surveillance—United States, 2015. Morbidity and
7
Champion, K. E., Newton, N. C., & Teesson, M. Mortality Weekly Report: Surveillance Summaries, 65,
(2016). Prevention of alcohol and other drug use and 1-174.
related harm in the digital age: What does the 17
Kim, C. R., & Free, C. (2008). Recent evaluations of
evidence tell us? Current Opinion in Psychiatry, 29, the peer-led approach in adolescent sexual health
242-249. education: A systematic review. Perspectives on
8
Connolly, K. (2020). Supporting gender expansive Sexual and Reproductive Health, 40, 144-151.
youth: Considerations for 18
Lee, N. K., Cameron, J., Battams, S., & Roche, A.
healthcare providers. UConn Collaboratory on School (2016). What works in school-based alcohol
and Child Health. https://csch.uconn.edu/wp- education: A systematic review. Health Education
content/uploads/sites/2206/2020/01/CSCH-Brief- Journal, 75(7), 780–798.
Supporting-Gender-Expansive-Youth-Final-1-14- 19
Lemstra, M., Bennett, N., Nannapaneni, U.,
20.pdf Neudorf, C., Warren, L., Kershaw, T., & Scott, C.
9
Dessel, A. B., Kulick, A., Wernick, L. J., & Sullivan, (2010). A systematic review of school-based
D. (2017). The importance of teacher support: marijuana and alcohol prevention programs targeting
Differential impacts by gender and sexuality. Journal adolescents aged 10–15. Addiction Research &
of Adolescence, 56, 136-144.Dessel, A. B., Kulick, A.,
Theory, 18, 84-96.
Wernick, L. J., & Sullivan, D. (2017). The importance 20
Lize, S. E., Iachini, A. L., Tang, W., Tucker, J.,
of teacher support: Differential impacts by gender and Seay, K. D., Clone, S., DeHart, D., & Browne, T.
sexuality. Journal of Adolescence, 56, 136-144. (2017). A meta-analysis of the effectiveness of
10
Dudley, D. A., Cotton, W. G., & Peralta, L. R. interactive middle school cannabis prevention
(2015). Teaching approaches and strategies that programs. Prevention Science, 18(1), 50–60.
promote healthy eating in primary school children: A 21
Meiklejohn, S., Ryan, L., & Palermo, C. (2016). A
systematic review and meta-analysis. The systematic review of the impact of multi-strategy
International Journal of Behavioral Nutrition and nutrition education programs on health and nutrition of
Physical Activity, 12, 1-26. adolescents. Journal of Nutrition Education and
11
Elder, R. W., Nichols, J. L., Shults, R. A., Sleet, D. Behavior, 48(9), 631–646.
A., Barrios, L. C., & Compton, R. (2005). 22
Melendez-Torres, G. J., Tancred, T., Fletcher, A.,
Effectiveness of school-based programs for reducing Thomas, J., Campbell, R., & Bonell, C. (2018). Does
drinking and driving and riding with drinking integrated academic and health education prevent
drivers. American Journal of Preventive Medicine, 28, substance use? Systematic review and meta‐
288-304. analyses. Child: Care, Health and Development,
44(4), 516–530.

V3. WSCC Practice Brief: Health Education was created by the UConn Collaboratory on School and Child Health.
Copyright © 2018, 2020, 2021 by the University of Connecticut. 5

All rights reserved. Permission granted to photocopy for personal and educational use as long as the names of the
creators and the full copyright notice are included in all copies.

csch.uconn.edu | @UConnCSCH
23 28
Michael, S. L., Merlo, C. L., Basch, C. E., Wentzel, Price, C., Cohen, D., Pribis, P., & Cerami, J. (2017).
K. R., & Wechsler, H. (2015). Critical connections: Nutrition education and body mass index in grades K-
Health and academics. Journal of School Health, 85, 12: A systematic review. Journal of School Health,
740-758. 87(9), 715–720.
24 29
Mirzazadeh, A., Biggs, M. A., Viitanen, A., Horvath, Rasberry, C. N., Tiu, G. F., Kann, L., Mcmanus, T.,
H., Wang, L. Y., Dunville, R., Barrios, L. C., Kahn, J. Michael, S. L., Merlo, C. L., Lee, S.M., Bohm, M.K.,
G., & Marseille, E. (2018). Do school-based programs Annor, F., Ethier, K. A. (2017). Health-related
prevent HIV and other sexually transmitted infections behaviors and academic achievement among high
in adolescents? A systematic review and meta- school students — United States, 2015. MMWR.
analysis. Prevention Science, 19(4), 490–506. Morbidity and Mortality Weekly Report, 66, 921-927.
25
National Academies of Sciences, Engineering, and 30
Sandler, I., Wolchik, S. A., Cruden, G., Mahrer, N.
Medicine. (2019). Fostering healthy mental, E., Ahn, S., Brincks, A., & Brown, C. H. (2014).
emotional, and behavioral development in children Overview of meta-analyses of the prevention of
and youth: A national agenda. The National mental health, substance use, and conduct problems.
Academies Press. Annual Review of Clinical Psychology, 10, 243-273.
26
Onrust, S. A., Otten, R., Lammers, J., & Smit, F. 31
Shackleton, N., Jamal, F., Viner, R. M., Dickson, K.,
(2016). School-based programmes to reduce and Patton, G., & Bonell, C. (2016). School-based
prevent substance use in different age groups: What interventions going beyond health education to
works for whom? Systematic review and meta- promote adolescent health: Systematic review of
regression analysis. Clinical psychology review, 44, reviews. Journal of Adolescent Health, 58, 382-396.
45–59. 32
27
Strøm, H. K., Adolfsen, F., Fossum, S., Kaiser, S., &
Poobalan, A. S., Pitchforth, E., Imamura, M., Martinussen, M. (2014). Effectiveness of school-
Tucker, J. S., Philip, K., Spratt, J., & ... van Teijlingen, based preventive interventions on adolescent alcohol
E. (2009). Characteristics of effective interventions in use: A meta-analysis of randomized controlled
improving young people's sexual health: A review of trials. Substance Abuse Treatment, Prevention, and
reviews. Sex Education, 9, 319-336. Policy, 9, 1-11.

To cite this brief: Iovino, E. A., Chafouleas, S. M., Perry, H. Y., Anderson, E., Koslouski, J.,
& Marcy, H. M. (2021, August). V3. WSCC Practice Brief: Health Education. Storrs, CT:
UConn Collaboratory on School and Child Health.
Acknowledgements: We thank Drs. B. Edmondson, T. Koriakin and J. Concannon for their
support and expertise in developing Version 1 of this brief.

V3. WSCC Practice Brief: Health Education was created by the UConn Collaboratory on School and Child Health.
Copyright © 2018, 2020, 2021 by the University of Connecticut. 6

All rights reserved. Permission granted to photocopy for personal and educational use as long as the names of the
creators and the full copyright notice are included in all copies.

csch.uconn.edu | @UConnCSCH