Teaching an Evidence-Based Curriculum
Maintaining fidelity to the evidence base of the curriculum is very important. This means teaching the program as intended and following the curriculum used in the original research study that yielded results. Minor or “green-light” adaptations to optimize a program for the young people receiving it are acceptable. These would include updating statistics and changing names or editing language in scenarios and roleplays to better reflect the youth population receiving the program. Other allowable enhancements include adding lessons before or after the curriculum lessons to address additional health issues, and lengthening sessions to allow more time for review, discussion, questions and additional roleplay practice.
Adaptations such as re-ordering the curriculum lessons or inserting additional content into the middle of the program are considered “yellow-light” adaptations because they can have an impact on program flow and effectiveness. These changes should be discussed and approved by the program developers or funders ahead of time.
Major changes (also referred to as “red-light” adaptations) are discouraged and may significantly affect and alter program effectiveness. Examples of major changes include dropping entire activities or lessons, or altering the key messages of the program.
Characteristics of Effective Programs
The Centers for Disease Control and Prevention has identified the key characteristics of effective health education curricula. These programs reflect the growing body of research that emphasizes teaching functional health information (essential knowledge); shaping personal values and beliefs that support healthy behaviors; shaping group norms that value a healthy lifestyle; and developing the essential health skills necessary to adopt, practice, and maintain health-enhancing behaviors.
An effective health education curriculum has the following characteristics, according to reviews of effective programs and curricula and experts in the field of health education:
Focuses on clear health goals and related behavioral outcomes. An effective curriculum has clear health-related goals and behavioral outcomes that are directly related to these goals. The instructional strategies and learning experiences are directly related to the behavioral outcomes.
Is research-based and theory-driven. Effective curricula have instructional strategies and learning experiences built on theoretical approaches that have effectively influenced health-related behaviors among youth. The most promising programs go beyond the cognitive level and address health determinants, social factors, attitudes, values, norms and skills that influence specific health-related behaviors.
Addresses individual values, attitudes and beliefs. An effective curriculum fosters attitudes, values and beliefs that support positive health behaviors. It provides instructional strategies and learning experiences that motivate students to examine their personal beliefs, attitudes and values, and understand their own risk behaviors, in support of adopting health-enhancing actions.
Addresses individual and group norms that support health-enhancing behaviors. An effective curriculum provides instructional strategies and learning experiences to help students accurately assess the level of risk-taking behavior among their peers, correct misperceptions, and reinforce positive norms and health-enhancing beliefs.
Focuses on reinforcing protective factors and increasing perceptions of personal risk and harmfulness of engaging in specific unhealthy practices and behaviors. Effective curricula offer opportunities for students to assess their own risks and positive health behaviors, recognize their vulnerability to health problems, and examine influences that can support positive health behaviors, as well as those that can lead them to take risks.
Addresses social pressures and influences. Analyzing influences is a key skill that allows students to examine the effects of social pressures and the influence of family, peers, culture, media and technology on their health choices and behaviors.
Builds personal competence, social competence, and self-efficacy by addressing skills. An effective curriculum builds essential skills, including analyzing influences, accessing accurate and credible resources, communicating clearly, resisting pressure using refusal and negotiation tactics, decision making, goal setting and self-management. This skills focus helps students build confidence, deal with pressures, and avoid or reduce risk behaviors. Each skill should be thoroughly explained, discussed, modeled and practiced, with opportunities for students to receive feedback and reinforcement.
Provides functional health knowledge that is basic, accurate, and directly contributes to health-promoting decisions and behaviors. Functional information in effective curricula comes from accurate, reliable and credible sources and is taught in the context of improving knowledge and skills in order to practice healthy behaviors. Students are given ample opportunities to apply the information they are learning to their own lives in the interest of making health-enhancing choices.
Uses strategies designed to personalize information and engage students. An effective curriculum includes instructional strategies and learning experiences that are student-centered, interactive and experiential. Learning experiences correspond with students’ cognitive and emotional development, help them personalize information, and maintain their interest and motivation while accommodating diverse capabilities and learning styles. Instructional strategies and learning experiences include methods for:
- Addressing key health-related concepts
- Encouraging creative expression
- Sharing personal thoughts, feelings, and opinions
- Thoughtfully considering new arguments
- Developing critical thinking skills
Provides age-appropriate and developmentally appropriate information, learning strategies, teaching methods and materials. An effective curriculum addresses students’ needs, interests, concerns, developmental and emotional maturity levels, experiences, and current knowledge and skill levels. The lessons are designed to build the learning about the topic and help students apply their new knowledge and skills to their lives. Activities are grade-appropriate for the intended youth population, and concepts and skills are covered in a logical sequence.
Incorporates learning strategies, teaching methods and materials that are culturally inclusive. An effective curriculum has materials designed to be unbiased and inclusive of diverse cultures and lifestyles (such as gender, race, ethnicity, age, ability and sexual orientation). Learning activities acknowledge the cultural diversity of students; optimize relevance to students from multiple cultures in the school community; and build on the cultural resources of families and communities.
Provides adequate time for instruction and learning. An effective curriculum provides enough time to promote understanding of key concepts and practice skills. It is intended to build the learning on a particular health topic sequentially and logically to help ensure student mastery of those concepts and skills. Behavior change requires an intensive and sustained effort. A short-term or single-shot curriculum, delivered for a few hours at one grade level, is generally insufficient to support the adoption and maintenance of healthy behaviors.
Provides opportunities to reinforce skills and positive health behaviors. An effective curriculum builds on previously learned concepts and skills and provides opportunities to reinforce health-promoting skills across health topics and grade levels. Skill practice is often extended beyond a single activity or lesson, and students continue to practice and build their understanding and application of the skills. A curriculum that addresses age-appropriate determinants of behavior across grade levels and that reinforces and builds on previous learning is more likely to achieve longer-lasting results.
Provides opportunities to make positive connections with influential others. An effective curriculum links students to influential others who affirm and reinforce health-promoting norms, attitudes, values, beliefs and behaviors. Activities help students connect with trusted adults in their lives for information, advice and reinforcement of the concepts, skills and healthy behaviors. Instructional strategies build on protective factors by engaging peers, parents, families and other positive adult role models in student learning.
Includes teacher information and plans for professional development and training that enhance effectiveness of instruction and student learning. Ongoing professional development and training is critical for helping teachers implement a new curriculum with fidelity.