Preservice teachers' attitudes toward teaching health education

American Journal of Health Studies, Fall, 2000 by Dolores W. Maney, Helene L. Monthley, Joanna Carner

Abstract: Researchers explored the influence of three-credit elementary-level focused Health Education methods-intensive courses on preservice teachers' attitudes, familiarity, and confidence toward comprehensive school health education. Reliability and validity measures were calculated, and found to be acceptable. The population consisted of 170 preservice education majors. Frequency analysis, non-parametric tests, and bivariate analytic procedures were used. Results showed significant increases in "ability to recall content" and "confidence to teach "school health content. At posttest, respondents felt significantly more "confident in their ability" to teach only five of the following 10 school health content: (1) mental health, (2)substances, (3) body systems/growth and development, (4) nutrition, and (5) injury prevention/safety. Recommendations for future research were made.

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The purpose of this study was to assess the effect of a three-credit methods-intensive health education course on preservice teachers' attitudes toward coordinated school health. This introduction contains a brief review of school health education, priority areas for child health promotion and disease prevention, the national health education standards, and current school health education models used for university-level preservice teacher training. In addition, a description of issues related to inadequate teacher preparation programs, teachers' confidence regarding implementing health education, and the need for more sophisticated assessments of the preservice training are presented.

Both historically and contemporarily, the need for health education has been well-documented (Allensworth & Kolbe, 1987; Centers for Disease Control and Prevention [CDC], 1991; Cortese, 1993; Cortese & Middleton, 1994; Joint Committee on National Health Education Standards (1995); McKenzie, & Richmond, 1998; Nader, 1990). While school age children historically were at risk for communicable diseases leading to high child fatality rates (Cortese, 1993), presently many children and adolescents engage in risk behaviors that may jeopardize their self-esteem and health, and increase the likelihood of illness, injury, and premature death (Cortese & Middleton, 1994; Meeks, Heit & Page, 1996; Nader, 1993). Specifically, in 1991, the CDC reported that the following six behaviors, often established during childhood, contribute markedly to today's leading causes of death: (1) tobacco use, (2) unhealthy dietary behavior, (3) inadequate physical activity, (4) alcohol and other drug use, (5) sexual behaviors, and (6) intentional and unintentional injuries. Finally, the CDC (1991) has highlighted other major problems of American youth, noting, for example, that "every day, nearly 3,000 young people take up smoking;" "daily participation in high-school physical education classes dropped from 42% in 1991 to 27% in 1997;" "almost three-fourths of young people don't consume the recommended number of fruits and vegetables each day;" and "every year almost one million adolescents become pregnant, and about three million become infected with a sexually transmissible disease" (p. 2).

With the guidance of the Coordinated School Health Program (CSHP) model, elementary education teachers play a crucial role in assisting children and adolescents learn how to assume healthful and productive lives and reduce these risk behaviors (CDC, 1991). It is during preservice training that comprehending the CSHP model is of most importance. The CSHP model is designed to give elementary education majors a picture of health education beyond classroom instruction that ultimately improves the health status of children, youth, families, and communities (Lavin, 1993). Traditionally, health education at the elementary (K-6) level is the responsibility of the classroom teacher (i.e., inservice teacher), who unfortunately receives little, if any, preservice training in health (American School Health Association, 1993, p. 54). It is unclear whether the preservice teachers, who have fulfilled a methods-intensive health education course, are truly confident in their ability to teach health as part of the daily curriculum (Torabi, et al., 1999). It is probable, in fact, that one's motivations for learning how to teach health at the elementary level are related to confidence levels, or attitudes toward the subject in general.

Becoming a health literate individual also is a goal of preservice training. The four bases of the health literate individual, as defined by the National Health Education Standards, include being a: (1) critical thinker and problem solver, (2) responsible and productive citizen, (3) self-directed learner, and (3) effective communicator (Joint Committee on National Health Education Standards, 1995). In concert with these health literacy objectives, six specific health education standards targeting Kindergarten through grade four have been devised. Further supporting the need for health education, these developmentally appropriate standards provide that students: (1) comprehend concepts related to health promotion and disease prevention; (2) demonstrate the ability to access valid health information and health-promoting products and services; (3) practice health-enhancing behaviors and reduce health risks; (4) analyze the influence of culture, media, technology, and other factors on health; (5) use interpersonal communication skills to enhance health; and (6) use goal setting and decision-making skills to enhance health (Joint Committee on National Health Education Standards, 1995, pp. 27-29). The relevance of national health education standards, theoretical school health models, and priority areas for prevention aside, the choice to implement health education at the elementary-level ultimately lies with the elementary inservice teacher.