Criteria for Effective Health & Personal-Social Development Curricula

(An item from the ISHN Member information service)  With UNESCO and other UN agencies in the midst of developing indicators for student learning outputs as part of the new 2015-2030 Social Development Goals, our attention has turned to sources of advice about high quality HPSD education and curricula. Here are some good sources.
The association representing Personal-Social-Health-Economic Education (PSHE) in the UK provides an excellent summary in a blog posting on the characteristics of effective health and social development curricula. The list includes " some common elements of good practice, summarised here and available in greater detail in our ‘Case study key findings document’:

• A discrete, developmental and responsive PSHE education programme at the centre of the school curriculum, providing  opportunities to teach concepts, knowledge, language, strategies and skills that enrich the wider curriculum.
  
• PSHE education managed by an experienced, central co-ordinator with a genuine passion for the subject in their school. This co-ordinator should be supported by a ‘whole school’ commitment to PSHE education, and be part of a single data-driven system under which pupil personal development and pastoral care are provided.
  
• A senior leadership committed to monitoring the quality of PSHE teaching with the same rigour and expectations as other subjects. This also helps to ensure that any PSHE lessons observed during an Ofsted inspection can contribute positively to the overall judgment.
  
• Active involvement from members of the senior leadership team in teaching PSHE. Senior leadership team members’ involvement  - for example through heads of years teaching certain modules -  raises the profile and status of the subject with staff and pupils.
  
• PSHE education built around clear learning objectives and expected learning outcomes. Robust teacher, pupil and peer assessment allows schools to demonstrate pupils’ immediate learning from a single lesson and their progress over time. Schools should gather data to focus, evaluate and evidence the impact of the school’s PSHE provision. This ‘data rich’ environment also provides a strong evidence base for Ofsted inspections.
  
• PSHE education treated with the same regard as other subjects on the school’s curriculum. PSHE should be given appropriate curriculum time and a developmental scheme of work, have lessons observed and ensure that pupils’ work and progression is subject to scrutiny.
  
• Clear learning objectives which differentiate PSHE education where it is ‘blended’ with other subjects.  Some secondary schools ‘blend’ PSHE education, citizenship and RE whilst others separate them out as discrete timetabled subjects. Regardless of the model there should be clear learning objectives and outcomes for each element.
  
• Scope for flexibility and creativity to change the direction of lessons in response to pupil need.  This flexibility should take place within a wider framework ensuring that pupils would return to the planned learning at a later date.
  
• Recognition by schools that PSHE education helps to develop transferable skills that support academic success and success in life beyond school.  Schools should recognise PSHE education’s role in developing interpersonal skills such as listening, questioning, team-working and risk identification and its impact on pupils’ academic achievement, behaviour and success beyond school, including employability.
  
• A single ‘unifying framework’ or philosophy that focuses the entire school’s curriculum, making it clear to staff how the content and pedagogy of PSHE education contributes to this ethos.
  
• External visitors used within the context of a planned PSHE programme. Carefully selected external visitors can be used to enrich learning, provide expert input and act as role models with pre and post learning  offered through the regular planned PSHE programme.
  
• Active involvement of governing bodies. As part of their scrutiny of the curriculum, governing bodies should be provided with reports of pupils’ progress in PSHE and intended developments in the subject. Strong links with the student council should also be encouraged.

The Center for Disease Control & Prevention in the USA also provides excellent advice in their review of several Characteristics of an Effective Health Education Curriculum:

1. Focuses on clear health goals and related behavioral outcomes
2. Is research-based and theory-driven.
   
3. Addresses individual values, attitudes, and beliefs
4. Addresses individual and group norms that support health-enhancing behaviors
5. Focuses on reinforcing protective factors and increasing perceptions of personal risk and harmfulness of engaging in specific unhealthy practices and behaviors.
6. Addresses social pressures and influences.
7. Builds personal competence, social competence, and self efficacy by addressing skills
8. Provides functional health knowledge that is basic, accurate, and directly contributes to health-promoting decisions and behaviors
9. Uses strategies designed to personalize information and engage students.
10. Provides age-appropriate and developmentally-appropriate information, learning strategies, teaching methods, and materials
11. Incorporates learning strategies, teaching methods, and materials that are culturally inclusive.
12. Provides adequate time for instruction and learning.
13. Provides opportunities to reinforce skills and positive health behaviors
14. Provides opportunities to make positive connections with influential others
15. Includes teacher information and plans for professional development and training that enhance effectiveness of instruction and student learning.

The Glossary Term on Health Personal and Social Development Education being developed by the International School Health Network on its Wikipedia style web site has listed these important student learning outputs as part of its description of effective health and social development education.
There are several types of learning objectives that can be achieved in effective HPSD curricula and programs. These include:

• Focusing on functional or practical knowledge rather than simply presenting facts about health/social issues (eg too much detail on how STI are transmitted and not on enough on the fact that a person can have an STI and still look healthy)
• Developing and practicing general social, decision-making, life, media and decision-making/reasoning skills as well as practice and rehearsals in skills for specific situations (such as refusing alcohol)
• Promoting specific, practical age-appropriate behaviours (e.g. how to discuss/negotiate/refuse sex with partner) and providing specific pre-planned situational options (e.g. having a back-up drive home from parties) that can be sustained by the students rather than general and unrealistic calls for abstinence, alarmist messages contrary to prevailing social norms (alcohol is bad for you in communities where most adults drink)
• Addressing social pressures and influences through media literacy education, instruction about puberty, relationships with peers and peer pressure, how to communicate with parents and other adults
• Influencing normative beliefs, perceptions and attitudes through deconstructing mis-perceptions and providing factual information and investigation of collective behaviours of their peers/fellow students
• Personalizing information and risks about health and social problems and behaviours through inquiry-based learning, reflective journalling, role plays and other activities
• Developing behavioural intentions or personalized action plans through class discussions, buddy-based projects, external presentations
  
• Increasing self-awareness and awareness of the values and expectations of their parents, schools and communities
• Developing stronger empathy with others and greater social responsibility for promoting the health and welfare of others
  
• Learning how to access and use health services by visiting physicians offices, health clinics
  

Health literacy is a newer concept in health promotion that has not yet been applied extensively to school health education. We have always been trapped into developing health education by health topics (rather than generic skills or even basic skills/knowledge as in HL) so we do not have an evidence-based, experience-tested set of student learning outputs for all topics that can be developed in context relevant sets as a realistic, minimal output for schools.

Linking health instruction inextricably with health services and other components of a comprehensive school health approach. There are a number of models of health education, particularly from sex education that has linked instruction with convenient, accessible services, or ensuring nutrition education goals are reflected in the school cafeteria are examples. The IVAC model developed in Denmark and used widely in Europe has flipped the instructional paradigm by using a student action learning framework as its basis rather than the traditional behavourist model.